Predictors of hospital mortality in patients with ruptured abdominal aortic aneurysm

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Abstract

Purpose:Recently, the results of elective surgery for abdominal aortic aneurysms have become safety, whereas those of emergency surgery for cases of rupture remain high mortality rate. In the present study, we investigated the risk factors of surgery for a ruptured abdominal aortic aneurysm. Methods:We studied 51 patients who underwent emergency surgery for a ruptured abdominal aneurysm from January 1979 to December 2006 at Toyama University Hospital. We analyzed preoperative and operative factors. The factors were analyzed using multivariate logistic regression analysis. Results: Fourteen patients died (hospital mortality 27.5%). The factors were examined using stepwise logistic analysis to investigate hospital deaths in cases with a ruptured abdominal aortic aneurysm, which revealed that Postoperative organ failure (OR 32.4, p=0.004), intraoperative bleeding of 5000 ml or more (OR 6.76, p=0.039), preoperative base excess in arterial blood of ?5 or lower (OR 9.30, p=0.008), and diabetes mellitus (OR 9.02, p=0.062). Conclusion: Risk factors of death from direct surgery for ruptured abdominal aortic aneurysm were investigated by multivariate analysis, and complication by diabetes, postoperative organ failure,5000ml or more blood loss during surgery, and ?5 or lower base excess in preoperative arterial blood were identified as highly associated factors.

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