Objective: To assessed the relationships between hemoglobin concentration from the patients with abdominal aortic aneurysm (AAA) and its diameter as well as patients' long-term survival.
Methods: Between January 2002 to June 2012, 255 AAA patients were reviewed retrospectively. The outcomes were compared between 3 groups of different treatments (excluding 20 cases dead within 30 days). The procedures included open AAA repair (n=76), endovascular (EVAR) (n=62) and non-operated (n=97). The mean follow-up period was 63±42 months. The association of hemoglobin level with AAA diameter was assessed with multiple linear regression. Kaplan-Meier survival curves of anemic and non-anemic patient groups were compared by the log-rank method in 3 groups. Cox's proportional hazard regression mode was used to determine the effects of anemia on vital status after EVAR, open AAA repair or non-operation.
Results: A total of 88 (34.5%) of AAA patients had anemia. After adjustment for various risk factors, hemoglobin level was inversely correlated with maximal AAA diameter (β=-0.152, P=0.017). During a long-term follow-up, the 5-year survival rates were 56%, 51% and 42% in anemic patients versus 94%, 90% and 80% in non-anemic ones. Survival was lower in anemic patients than those without anemia in 3 groups (P=0.005, 0.001, 0.025 by log-rank respectively). In three groups, according to multivariable Cox regression analysis, the hemoglobin levels were independently correlated with long-term mortality respectively after adjusting for various risk factors. The hemoglobin levels were correlated with death (HR: 0.923, 0.963, 0.963; P: 0.001, 0.002, 0.028; 95%CI: 0.8798-0.970, 0.941-0.986, 0.932-0.996).
Conclusion: Hemoglobin concentration is independently associated with AAA diameter and reduced long-term survival after undergoing EVAR, open AAA repair and non-operation.