Factors Increasing the Mortality Rate for Patients with Ruptured Abdominal Aortic Aneurysms
| Autor: | M, Alonso-Pérez, R J, Segura, J, Sánchez, G, Sicard, A, Barreiro, M, García, P, Díaz, X, Barral, M A, Cairols, E, Hernández, A, Moreira, T P, Bonamigo, S, Llagostera, M, Matas, N, Allegue, A H, Krämer, R, Mertens, A, Coruña |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Male
medicine.medical_specialty Aortic Rupture medicine.medical_treatment Blood Pressure Inferior mesenteric artery Aortic aneurysm Postoperative Complications Aneurysm Predictive Value of Tests Risk Factors Internal medicine medicine.artery medicine Humans Hospital Mortality Ligature Aged Aged 80 and over Univariate analysis Vascular disease business.industry Mortality rate Age Factors General Medicine Middle Aged Surgical Instruments medicine.disease Survival Analysis Surgery Logistic Models Treatment Outcome Hematocrit Creatinine cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Aortic Aneurysm Abdominal Abdominal surgery |
| Zdroj: | Annals of Vascular Surgery. 15:601-607 |
| ISSN: | 0890-5096 |
| DOI: | 10.1007/s100160010115 |
| Popis: | The objective of this report was to analyze the current surgical results of operative treatment in patients suffering ruptured AAA (abdominal aortic aneurysms) and to define those independent predictive factors for mortality. During a period of 2 years, from January 1996 to December 1997, 144 patients operated on for ruptured AAA in 10 hospitals were included in a multicenter retrospective study. Among the collected variables concerning each patient, those with potential relation to surgical mortality were studied: gender, age, diabetes, hypertension, cardiopathy, pulmonary obstructive disease, preoperative renal dysfunction, symptomatic cerebrovascular disease, peripheral vascular disease, hematocrit on admission, preoperative hypotension < 80 mmHg, loss of consciousness, cardiac arrest, aortic aneurysm location (infrarenal versus non-infrarenal), iliac involvement, aneurysm size, type of rupture, left renal vein ligature, ligature of a patent inferior mesenteric artery, place of aortic cross-clamping, type of grafting, exclusion of both hypogastric arteries, venous technical complications, associated surgery, use of cell saver, intraoperative blood loss, and postoperative complications (renal failure, sepsis, coagulopathy, cardiac complications, pulmonary complications, colon ischemia, prosthetic graft complications, and need for reoperation). Those variables with statistical significance in the univariate analysis were introduced into a multivariate logistic regression model to determine the independent predictors of death. From our results we concluded that surgery for ruptured abdominal aortic aneurysms continues to have an excessively high mortality rate. Even though some preoperative variables could be identified as predictors of mortality, an absolute mortality risk has not yet been determined and the decision to negate surgery should be individualized rather than taken on that basis only. Early diagnosis and treatment of symptomatic aneurysms would improve mortality figures and selective screening should be contemplated. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink