Document Detail


Determinants of postoperative and long-term survival of patients with ruptured abdominal aortic aneurysms.
MedLine Citation:
PMID:  9505314     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To compare the surgical results of patients with ruptured (rAAA) and nonruptured abdominal aortic aneurysms (NrAAA), 267 consecutive patients surgically treated for abdominal aortic aneurysms (AAA) were reviewed. The patients' characteristics, preexistent risk factors, perioperative factors, and postoperative early and long-term survival were compared between the rAAA group (n = 27) and the NrAAA group (n = 240). A multivariate analysis to predict postoperative survival was also conducted in the rAAA group. The hospital mortality rate was 3.3% (8/232) for the NrAAA group and 22.2% (6/27) for the rAAA group (P < 0.001). The maximum size of aneurysms, period of preoperative hypotension, and intraoperative bleeding volume were significantly higher in the rAAA group than in the NrAAA group. The 5- and 10-year cumulative survival rates in the rAAA group were 88.1% and 42.0%, which were comparable to those in the NrAAA group. The incremental risk factors for hospital death in the rAAA group included advanced age, preoperative hypotension (< 80 mmHg), and postoperative renal failure requiring dialysis. These findings showed that the interval from rupture to cross-clamping must be shortened, maintaining hemodynamic stability to avoid prolonged hypotension. Reducing risk factors and minimizing deterioration of organ functions postoperatively would be essential to improve the prognosis of patients with rAAA.
Authors:
S Sasaki; K Yasuda; H Yamauchi; N Shiiya; M Sakuma
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgery today     Volume:  28     ISSN:  0941-1291     ISO Abbreviation:  Surg. Today     Publication Date:  1998  
Date Detail:
Created Date:  1998-05-08     Completed Date:  1998-05-08     Revised Date:  2006-08-03    
Medline Journal Info:
Nlm Unique ID:  9204360     Medline TA:  Surg Today     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  30-5     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Hokkaido University Hospital, Sapporo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aortic Aneurysm, Abdominal / mortality*,  surgery
Aortic Rupture / mortality*,  surgery
Case-Control Studies
Cause of Death
Female
Hospital Mortality
Humans
Male
Multivariate Analysis
Postoperative Period
Risk Factors
Survival Analysis
Survival Rate
Survivors
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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