Predictive Factor for Mortality and Morbidity of Abdominal Aortic Aneurysm Repair

Abstract

Manabu Shiraishi, Kei Aizawa, Yasuhito Sakano, Yuichiro Kaminishi, Shin-ichi Ohki, Tsutomu Saito, Yoshio Misawa

Purpose: This study aimed to determine the procedure-related morbidity and mortality of infrarenal abdominal aortic aneurysm (AAA) repair, to investigate the changes in perioperative laboratory values, and to clarify the specific independent predictive factors for mortality and morbidity. We retrospectively evaluated patients who were treated in Jichi Medical University Hospital. Methods: Consecutive patients with AAA between April 2007 and August 2010 were studied. The possible predictive values of various patient- and operation-related variables on outcomes (mortality, duration of stay in hospital (>7 days), and major morbidity) were assessed by multivariate analysis. Results: Overall in-hospital mortality was 3.3%. Statistically significant differences, all in favor of endovascular aneurysm repair (EVAR), were observed in the intraoperative and post-operative data. In multivariate logistic analysis, potassium, serum creatinine and C-reactive protein levels were significantly related to outcomes. Conclusions: Open repair and EVAR can both be safely performed in patients treated for elective and emergency infrarenal AAA. EVAR has perioperative advantages of reduced blood loss and blood transfusion, as well as decreased mortality and duration of post-operative hospital stay. In particular, we identified specific independent predictive factors of serum chemistry values for mortality and renal insufficiency