Predictive Factors for Mortality and Morbidity of Ruptured 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 morbidity and mortality of infrarenal ruptured abdominal aortic aneurysm (rAAA) repair, and to investigate the changes in perioperative laboratory values, as well as clarify the specific independent predictive factors for mortality and morbidity. We retrospectively evaluated patients who were treated in Jichi Medical University Hospital. Methods: A consecutive fifty-six patients with rAAA between April 2007 and August 2010 were studied. The possible predictive values of various patient-related variables on outcomes (mortality, major morbidity and renal insufficiency) were assessed by univariate and multivariate analysis. Results: The overall in-hospital mortality was 16.1%. In univariate logistic analyses, lactate dehydrogenase, alanine aminotransferase, as well as pre-operative and post-operative serum creatinine levels were significantly related to mortality. Blood transfusion volume, white blood cells and C-reactive protein levels were significantly related to major morbidity. Intraoperative blood loss, white blood cells, C-reactive protein levels, lactate dehydrogenase and pre-operative serum creatinine levels were significantly related to renal insufficiency. Conclusions: Emergency open repair can be safely performed in patients for infrarenal rAAA. In particular, we identified specific independent predictive factors of clinical examination and laboratory studies for mortality, major morbidity and renal insufficiency.