Open surgery in endovascular aneurysm repair era: simplified classification in two risk groups owing to factors affecting mortality in 137 ruptured abdominal aortic aneurysms (RAAAs)
| Autor: | Roberto Maffeis, Fabio Viotti, Nazario Portolani, Cristina Guadrini, Edoardo Cervi, Franco Nodari, Stefano Bonardelli, Maurizio De Lucia, Stefano Maria Giulini |
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| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis medicine.medical_treatment Aneurysm Ruptured Open surgery Endovascular aneurysm repair Risk Assessment Aortic aneurysm Aneurysm Aged Aged 80 and over Aneurysm Ruptured mortality/surgery Aortic Aneurysm Abdominal mortality/surgery Female Humans Male Middle Aged Prognosis Prospective Studies Retrospective Studies Risk Assessment Risk Factors Treatment Outcome Risk Factors medicine 80 and over Humans Prospective Studies Aged Retrospective Studies mortality/surgery Aged 80 and over Univariate analysis business.industry Retrospective cohort study Middle Aged medicine.disease Prognosis Surgery Treatment Outcome Original Article Female business Risk assessment Abdominal surgery Aortic Aneurysm Abdominal |
| Zdroj: | Updates in Surgery |
| ISSN: | 2038-3312 2038-131X |
| Popis: | Our objective is to identify in 137 true RAAAs operated consecutively in open surgery: (1) diagnostic therapeutic aspects capable of influencing results, (2) risk classes with different prognosis, (3) any situations where the prognosis is so negative that surgery is not recommended. The relationship of 16 anamnestic, clinical and technical parameters prospectively collected with 30-day mortality was retrospectively evaluated by uni- and multivariate analyses. Thirty-day mortality was 37%. The univariate analysis identified as mortality predictors Hb ≤ 8 g/dl and circulatory shock at hospitalisation, but following the multivariate analysis only circulatory shock was a certainly significant risk-factor. The cumulative effect on mortality of the two parameters identified at univariate analysis translates into a statistically significant difference in mortality between two groups of patients: A (no or just one risk-factor) and B (two risk-factors). To reinstate euvolemia, rather than adequate haemoglobin values, improves the chances of success. A simple prognostic index into two risk classes is feasible, but abstention from surgery is not justified in any type of patient. |
| Databáze: | OpenAIRE |
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