Treatment of ruptured abdominal aortic aneurysm, a permanent challenge or a waste of resources? Prediction of outcome using a multi-organ-dysfunction score.

Details

Serval ID
serval:BIB_BDC2FAEC4E84
Type
Article: article from journal or magazin.
Collection
Publications
Title
Treatment of ruptured abdominal aortic aneurysm, a permanent challenge or a waste of resources? Prediction of outcome using a multi-organ-dysfunction score.
Journal
European Journal of Vascular and Endovascular Surgery
Author(s)
Kniemeyer H.W., Kessler T., Reber P.U., Ris H.B., Hakki H., Widmer M.K.
ISSN
1078-5884
Publication state
Published
Issued date
2000
Peer-reviewed
Oui
Volume
19
Number
2
Pages
190-196
Language
english
Abstract
OBJECTIVES: in a retrospective study, attempts have been made to identify individual organ-dysfunction risk profiles influencing the outcome after surgery for ruptured abdominal aortic aneurysms. METHODS: out of 235 patients undergoing graft replacement for abdominal aortic aneurysms, 57 (53 men, four women, mean age 72 years [s.d. 8.8]) were treated for ruptured aneurysms in a 3-year period. Forty-eight preoperative, 13 intraoperative and 34 postoperative variables were evaluated statistically. A simple multi-organ dysfunction (MOD) score was adopted. RESULTS: the perioperative mortality was 32%. Three patients died intraoperatively, four within 48 h and 11 died later. A significant influence for pre-existing risk factors was identified only for cardiovascular diseases. Multiple linear-regression analysis indicated that a haemoglobin <90 g/l, systolic blood pressure <80 mmHg and ECG signs of ischaemia at admission were highly significant risk factors. The cause of death for patients, who died more than 48 h postoperatively, was mainly MOD. All patients with a MOD score >/=4 died (n=7). These patients required 27% of the intensive-care unit (ICU) days of all patients and 72% of the ICU days of the non-survivors. CONCLUSION: patients with ruptured aortic aneurysms from treatment should not be excluded. However, a physiological scoring system after 48 h appears justifiable in order to decide on the appropriateness of continual ICU support.
Keywords
Aged, Aneurysm, Ruptured, Aortic Aneurysm, Abdominal, Chi-Square Distribution, Female, Humans, Male, Multiple Organ Failure, Retrospective Studies, Risk Factors, Statistics, Nonparametric, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
29/01/2008 13:00
Last modification date
20/08/2019 15:32
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