Characteristics and outcomes of patients with infective native aortic aneurysm or vascular graft and endograft infection

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Abstract
Infections of the aorta and its branches can occur either in native tissue, known as infective native aortic aneurysms (INAAs), or following vascular surgery involving native or prosthetic grafts, referred to as vascular graft or endograft infections (VGEIs). First, this study aimed to assess the all-cause on-year mortality of patients with INAAs and VGEIs. Second, this study described patients' characteristics and prognostic factors. This observational study included patients hospitalised for INAA or VGEI, between 2014 and 2022, at Nancy University Hospital (France). Data were retrospectively collected from patients' medical record (ClinicalTrials.gov ID NCT05660733). Forty-seven patients were included in the INAAs group versus 40 in the VGEIs group. A history of immunosuppression or autoimmune disease were more frequent in INAAs patients. VGEIs patients had more chronic organ failure or cardiovascular pathology. The most commonly affected site was the infrarenal aorta, with thoracic involvement being more frequent in the INAAs group. Staphylococcus aureus was the most frequent identified pathogen (38.3% vs. 27.5%). There was no significant difference between groups in terms of all-cause 1-year mortality (40.4% in the INAAs group vs. 32.5% in the VGEIs group, log-rank test, p = .4803). The absence of surgery worsened the prognosis in the overall population (HR 2.8, 95% CI [1.2-6.3], p = .0125); this was also observed in the INAA group. Despite different comorbidities and clinical presentations between groups, there was no significant difference in 1-year mortality. Surgical management appeared to be associated with improved outcomes.

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