Perioperative outcomes after thoracic aortic surgery in Johannesburg: a retrospective observational cohort study, 1995-2023.
- 1Department of Anaesthesiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Abstract
Background
Thoracic aortic diseases require complex surgery, and outcomes data from African populations are scarce. We described the patient characteristic profile, documented risk factors, and perioperative outcomes of patients undergoing thoracic aortic surgery at a quaternary hospital in South Africa.Methods
In a retrospective cohort study reported per the Strengthening the Reporting of Observational Studies in Epidemiology guidelines, we included patients aged 18 yr or older who underwent open thoracic aortic surgery at Charlotte Maxeke Johannesburg Academic Hospital between 1995 and 2023. The primary outcome was in-hospital mortality. We assessed correlates using modified Poisson regression with robust variance (risk ratios [RRs]).Results
Of 366 patients (median age 48 yr [inter-quartile range 37-59]; 219 [59.8%] male), diagnoses were dissection in 157 (42.9%), aneurysm in 157 (42.9%), traumatic rupture in 26 (7.1%), and other in 26 (7.1%). In-hospital mortality was 21.9% (80 of 366; 95% confidence interval [CI] 17.7-26.4) and did not differ significantly across diagnosis groups (P=0.693), being identical after dissection and aneurysm (22.9% in each). Prolonged operative duration (>600 min) was the only variable independently associated with mortality (adjusted RR 7.2; 95% CI 1.5-34.9), an imprecise, sparse-data estimate. Mortality was numerically higher in female than male patients (26.2% vs 19.2%) but this difference was not significant after adjustment (adjusted RR 1.30; 95% CI 0.89-1.89); age and diagnosis were not independently associated.Conclusions
In-hospital mortality after thoracic aortic surgery was 21.9%. Prolonged operative duration was associated with in-hospital mortality, although the estimate was imprecise, and operative duration is likely to be a marker of procedural complexity and adverse intraoperative course rather than an independently modifiable risk factor. The findings support intensive postoperative care.
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BibTeX
@article{mmabatswa2026perioperative,
title = {{Perioperative outcomes after thoracic aortic surgery in Johannesburg: a retrospective observational cohort study, 1995-2023.}},
author = {Maserufe Marcia Mmabatswa and Amanda Nkuna and Kathy Vanderdonck and Moses Mogakolodi Kebalepile and Palesa Motshabi-Chakane},
journal = {BJA open},
year = {2026},
month = sep,
doi = {10.1016/j.bjao.2026.100891},
url = {https://europepmc.org/article/MED/42926805},
note = {CC BY},
}
RIS
TY - JOUR
TI - Perioperative outcomes after thoracic aortic surgery in Johannesburg: a retrospective observational cohort study, 1995-2023.
AU - Maserufe Marcia Mmabatswa
AU - Amanda Nkuna
AU - Kathy Vanderdonck
AU - Moses Mogakolodi Kebalepile
AU - Palesa Motshabi-Chakane
PY - 2026
DA - 2026/09/22
JO - BJA open
DO - 10.1016/j.bjao.2026.100891
UR - https://europepmc.org/article/MED/42926805
AB - Background Thoracic aortic diseases require complex surgery, and outcomes data from African populations are scarce. We described the patient characteristic profile, documented risk factors, and perioperative outcomes of patients undergoing thoracic aortic surgery at a quaternary hospital in South Africa.Methods In a retrospective cohort study reported per the Strengthening the Reporting of Observational Studies in Epidemiology guidelines, we included patients aged 18 yr or older who underwent open thoracic aortic surgery at Charlotte Maxeke Johannesburg Academic Hospital between 1995 and 2023. The primary outcome was in-hospital mortality. We assessed correlates using modified Poisson regression with robust variance (risk ratios [RRs]).Results Of 366 patients (median age 48 yr [inter-quartile range 37-59]; 219 [59.8%] male), diagnoses were dissection in 157 (42.9%), aneurysm in 157 (42.9%), traumatic rupture in 26 (7.1%), and other in 26 (7.1%). In-hospital mortality was 21.9% (80 of 366; 95% confidence interval [CI] 17.7-26.4) and did not differ significantly across diagnosis groups (P=0.693), being identical after dissection and aneurysm (22.9% in each). Prolonged operative duration (>600 min) was the only variable independently associated with mortality (adjusted RR 7.2; 95% CI 1.5-34.9), an imprecise, sparse-data estimate. Mortality was numerically higher in female than male patients (26.2% vs 19.2%) but this difference was not significant after adjustment (adjusted RR 1.30; 95% CI 0.89-1.89); age and diagnosis were not independently associated.Conclusions In-hospital mortality after thoracic aortic surgery was 21.9%. Prolonged operative duration was associated with in-hospital mortality, although the estimate was imprecise, and operative duration is likely to be a marker of procedural complexity and adverse intraoperative course rather than an independently modifiable risk factor. The findings support intensive postoperative care.
SN - 2772-6096
ER -