Risk Factors for Mortality in Patients with Aortoesophageal Fistula Related to Aortic Lesions
Table 1
Demographic, clinical, radiographic, and endoscopic findings of patients with AEF.
Total
Survivors
Nonsurvivors
Male sex
63.1% (137/217)
62.7% (64/102)
63.5% (73/115)
1.000
Mean age (years)
<0.001
Type of AEF
0.077
Primary
44.7% (98/219)
51.5% (53/103)
38.8% (45/116)
Secondary
55.3% (121/219)
48.5% (50/103)
61.2% (71/116)
Comorbidity
Hypertension
34.5% (48/139)
28.8% (19/66)
39.7% (29/73)
0.212
Other arterial diseases
24.5% (34/139)
21.2% (14/66)
27.4% (20/73)
0.434
Coronary heart disease
13.7% (19/139)
16.7% (11/66)
11.0% (8/73)
0.459
COPD
12.9% (18/139)
12.1% (8/66)
13.7% (10/73)
0.806
Renal disease
12.2% (17/139)
9.1% (6/66)
15.1% (11/73)
0.312
Diabetes
9.4% (13/139)
4.5% (3/66)
13.7% (10/73)
0.082
Hyperlipidemia
7.2% (10/139)
3.0% (2/66)
11.0% (8/73)
0.101
Clinical presentation
Hemorrhage
86.3% (183/212)
86.0% (86/100)
86.6% (97/112)
1.000
Hemorrhagic shock
50.5% (105/208)
37.1% (36/97)
62.2% (69/111)
<0.001
Chest/abdominal/back pain
38.3% (79/206)
39.6% (38/96)
37.3% (41/110)
0.775
Dysphagia
11.7% (24/206)
12.5% (12/96)
10.9% (12/110)
0.829
Fever
25.2% (52/206)
27.1% (26/96)
23.6% (26/110)
0.631
Chiari’s triad
20.0% (41/205)
15.8% (15/95)
23.6% (26/110)
0.220
Elevated inflammatory markers
73.3% (63/86)
77.1% (27/35)
70.6% (36/51)
0.622
Positive cultures
27.9% (61/219)
26.2% (27/103)
29.3% (34/116)
0.652
Mycotic AA
7.8% (17/219)
6.8% (7/103)
8.6% (10/116)
0.801
Imaging features
Mediastinal air bubbles in CT
39.9% (71/178)
35.2% (32/91)
44.8% (39/87)
0.221
Contrast leak in CT
11.2% (20/178)
8.8% (8/91)
13.8% (12/87)
0.346
Contrast leak in angiography
36.7% (11/30)
44.4% (8/18)
25.0% (3/12)
0.442
Contrast leak in esophagogram
73.7% (14/19)
60.0% (6/10)
88.9% (8/9)
0.303
Endoscopic features
Tumor-like submucosal mass
21.9% (35/160)
22.1% (17/77)
21.7% (18/83)
1.000
Blood clot
40.0% (64/160)
41.6% (32/77)
38.6% (32/83)
0.748
Mucosa necrosis
42.5% (68/160)
45.5% (35/77)
39.8% (33/83)
0.523
Pulsatile arterial bleeding
7.5% (12/160)
7.8% (6/77)
7.2% (6/83)
1.000
Visible aortic wall or graft
23.1% (37/160)
22.1% (17/77)
24.1% (20/83)
0.852
Type of aortic lesion
1.000
Aneurysm
84.5% (185/219)
84.5% (87/103)
84.5% (98/116)
Dissection
15.5% (34/219)
15.5% (16/103)
15.5% (18/116)
Location of fistula
Descending aorta
89.0% (195/219)
90.3% (93/103)
87.9% (102/116)
0.667
Aortic arch
17.4% (38/219)
15.5% (16/103)
19.0% (22/116)
0.593
Ascending aorta
2.7% (6/219)
3.9% (4/103)
1.7% (2/116)
0.424
Upper esophagus
19.4% (24/124)
18.6% (11/59)
20.0% (13/65)
0.743
Middle esophagus
66.1% (82/124)
62.7% (37/59)
69.2% (45/65)
0.455
Lower esophagus
16.1% (20/124)
18.6% (11/59)
13.8% (9/65)
0.626
Fistula size (cm)
(60/219)
(30/60)
(30/60)
0.391
Aneurysm size (cm)
(72/219)
(33/72)
(39/72)
0.015
Complications
38.4% (84/219)
28.2% (29/103)
47.4% (55/116)
0.004
Sepsis
23.3% (51/219)
10.7% (11/103)
34.5% (40/116)
<0.001
Multiorgan failure
5.0% (11/219)
0
9.5% (11/116)
0.001
Pulmonary complications
11.4% (25/219)
13.6% (14/103)
9.5% (11/116)
0.397
Renal failure
3.2% (7/219)
1.9% (2/103)
4.3% (5/116)
0.451
Neural complications
4.1% (9/219)
2.9% (3/103)
5.2% (6/116)
0.506
Aortic rupture
2.3% (5/219)
0
4.3% (5/116)
0.062
Fistula recurrence
6.8% (15/219)
6.8% (7/103)
6.9% (8/116)
1.000
Re-interventions within 30 d
2.7% (6/219)
2.9% (3/103)
2.6% (3/116)
1.000
Reinterventions unplanned after 30 d
6.4% (14/219)
7.8% (8/103)
5.2% (6/116)
0.582
AA: aortic aneurysm; AEF: aortoesophageal fistula; CT: computed tomography; SD: standard deviation. Data are counts, percentages, or medians. Numbers of patients with available data are shown in parentheses.
