Ruptured abdominal aortic aneurysms: predictors for early complications and death

Détails

ID Serval
serval:BIB_3E073DF91E44
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Ruptured abdominal aortic aneurysms: predictors for early complications and death
Périodique
Surgery
Auteur(s)
Bauer  E. P., Redaelli  C., von Segesser  L. K., Turina  M. I.
ISSN
0039-6060
Statut éditorial
Publié
Date de publication
07/1993
Peer-reviewed
Oui
Volume
114
Numéro
1
Pages
31-5
Notes
Journal Article --- Old month value: Jul
Résumé
BACKGROUND. Urgent operation for ruptured aneurysm is still associated with a high operative mortality rate. The purpose of the study was to determine the risk factors that truly influence early complications and death. METHODS. Between 1979 and 1991, 314 consecutive patients with a mean age of 69 years were treated surgically for a ruptured infrarenal abdominal aortic aneurysm. Twenty-two preoperative, perioperative, and intraoperative variables were subjected to a multivariate analysis to identify the independent predictors. RESULTS. Early death occurred in 92 (29%) of 340 patients. Significant primary predictors for early death were duration of cross-clamp (p < 0.0001), preoperative shock (p = 0.0005), suprarenal cross clamp (p = 0.002), and a history of coronary artery disease (CAD) (p = 0.004). The following postoperative complications were risk factors for death: myocardial failure (p < 0.0001), renal failure (p < 0.0001), sepsis (p = 0.01), and colon ischemia (p = 0.03). Predictors for postoperative myocardial insufficiency were a history of CAD (p < 0.0001), amount of intraoperative volume substitution (p < 0.0001), suprarenal cross clamp (p = 0.0007), and preoperative shock (p = 0.05). CONCLUSIONS. Preoperative and perioperative risk factors that result in fatal postoperative complications can be partially influenced by the surgeon. Short clamping time and infrarenal position of aortic clamp may lower overall early mortality rates. A history of CAD is a highly significant predictor for postoperative complications and early death.
Mots-clé
Aged Aortic Aneurysm, Abdominal/*complications/*mortality Aortic Rupture/*complications/*mortality Female Forecasting Humans Male Multivariate Analysis Postoperative Period Time Factors
Pubmed
Web of science
Création de la notice
14/02/2008 14:15
Dernière modification de la notice
20/08/2019 13:34
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