[Surgery of subrenal abdominal aortic aneurysms. Impact of anatomic factors and of comorbidity on perioperative morbidity and mortality].
OBJECTIVE
To determine the predictivity of anatomic and co-morbid factors for peri-operative mortality of patients operated for a non-ruptured abdominal aortic aneurysm (AAA).


METHODS
Between 1986 and 1996, data had been collected prospectively in a computerized date base. A chi-square test was performed for 5 anatomic, and 8 co-morbid criteria.


RESULTS
25 of 470 patients (5.3%) died within one month after surgery. Aneurysm diameter (P = 0.004) and aneurysmal internal iliac artery (P = 0.019) were associated with an increased mortality whereas upper extension of the disease necessitating a juxta-renal anastomosis, the need for inferior mesenteric artery reimplantation, or a symptomatic ilio-femoral occlusive disease, were not. Age (P = 0.016), obesity (P = 0.03), alteration of left ventricular function (P = 0.0014), and preoperative renal failure (P = 0.0001) were associated with increased mortality.


CONCLUSIONS
Both anatomic and co-morbid factors can predict outcome after elective surgery for non-ruptured AAA. The criteria might help to selection patients who might benefit from endovascular treatment of AAA.
Allaire
E
E
Service de Chirurgie Vasculaire, Hôpital Henri Mondor, Créteil.
Chemla
E
E
Becquemin
J P
JP
Mellière
D
D
Desgranges
P
P
D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000401:mortality / Q000601:surgery*; D016009:Chi-Square Distribution; D015897:Comorbidity; D019992:Databases as Topic; D006801:Humans; D007083:Iliac Artery / Q000033:anatomy & histology; D007668:Kidney; D017537:Mesenteric Artery, Inferior / Q000033:anatomy & histology / Q000601:surgery; D009017:Morbidity; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D012086:Reoperation; D012189:Retrospective Studies; D014656:Vascular Surgical Procedures / Q000401:mortality