Predictive preoperative factors of long-term survival rate after open surgery for abdominal aortic aneurysm

Objective: We aimed to examine long-term survival rate andthe risk factors of poor prognosis in patients whounderwent open surgery (OS) for abdominal aorticaneurysm (AAA).Materials and Methods: We performed a retrospective analysis of thepatients who underwent elective OS for AAAbetween 2005 and 2011 at Tokyo Medical andDental University Hospital. The relations betweenmortality rate and preoperative clinical factorswere examined.Results: For this study 195 patients were identified. Themortality was significantly related to size ofaneurysm, type of aneurysm, massive bleedingduring operation, age, anemia, uncontrolledhypertension, and comorbid chronic kidneydisease. No specific leading causes of death wereidentified for these increases in the mortalityrate. Cox proportional hazard model revealed thatanemia, hypertension, and chronic kidney disease(CKD) were independent predictive factors ofhigher mortality in the patients who underwent OSfor AAA.Discussion: In our previous study, high preoperative CRPlevel was correlated to long-term death rate afterendovascular aortic aneurysm repair (EVAR) forAAA. The difference might be attributed to the factthat OS relieves the aortic wall tension and reducesthe aortic inflammation, whereas EVAR does not,because of endoleak or endotension

Cluster analysis of patients with cough, mainly cough variant asthma, showing a good response to asthma therapy

Introduction: Cough variant asthma (CVA) and asthma account for a large proportion of patients with chronic cough. We used hierarchical cluster analysis (HCA) to characterize the phenotypes of patients with cough, mainly those with CVA, who showed a rapid response to asthma therapy, and sought to identify simple diagnostic markers. Methods: Patients who initially presented with cough as the main symptom were retrospectively enrolled. Those who were clinically diagnosed with asthma/CVA were selected and analyzed. HCA was performed and the patients were classified by phenotype. Results: HCA identified the five following phenotypes among the 221 participants: highly eosinophilic bronchitis [high fractional exhaled nitric oxide (FeNO) , n = 28]; atopic [high total serum IgE , n = 23]; non-atopic and non-eosinophilic [n = 104]; distal airway narrowing [low FEF75 (V ₂₅), n = 21] and severely atopic [extremely high total serum IgE and/or extreme high FeNO, n = 45]. No significant differences in long-term prognosis were found among the phenotypes. Discussion: Five phenotypes were identified among patients with cough who showed a rapid response to asthma treatment. Wheezing was observed in about 24% of patients, and abnormal FeNO or V₂₅ levels in about 30%