title: The post-operative mortality of ruptured abdominal aortic aneurysm repair.
abstract: BACKGROUND
  Late peri-operative death after ruptured abdominal aortic aneurysm (RAAA) repair is usually due to multiple-organ failure. The aim of this study was to identify any factors that are associated with mortality in this group of patients.
  
  
  METHODS
  A retrospective case-note review of a single decade's operative experience of RAAA repair in a single centre. Only those patients with confirmed rupture at laparotomy were included. Sixty-three pre- intra- and post-operative variables were recorded where possible for each patient who survived surgery and the initial 24-hours post-operatively. Multi-variate analysis was performed using stepwise logistic regression. The P-POSSUM, RAAA-POSSUM, RAAA-POSSUM (physiology only), V-POSSUM, and V-POSSUM (physiology only) models were all compared to determine how each performed in these patients.
  
  
  RESULTS
  Two hundred and twenty-three cases of confirmed RAAA were identified, of whom 139 survived the operation and initial 24-hours post-operatively. In-hospital mortality in this group of patients was 32.4%. Variables significantly associated with mortality after multi-variate analysis, were low intra-operative systolic blood pressure, the presence of a consultant anaesthetist at the initial operation and the development of cardiac, renal or gastro-intestinal complications. All POSSUM models except the V-POSSUM and P-POSSUM (physiology only) models demonstrated no significant lack of fit in this dataset.
  
  
  CONCLUSIONS
  Factors associated with delayed peri-operative death after RAAA are not the same as those previously found to be associated with overall peri-operative mortality after RAAA repair.
authors.affiliation: Department of Surgery, Leicester Royal Infirmary, University of Leicester, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Bown
authors.forename: N J
authors.initials: NJ
authors.lastname: Cooper
authors.forename: A J
authors.initials: AJ
authors.lastname: Sutton
authors.forename: D
authors.initials: D
authors.lastname: Prytherch
authors.forename: M L
authors.initials: ML
authors.lastname: Nicholson
authors.forename: P R F
authors.initials: PR
authors.lastname: Bell
authors.forename: R D
authors.initials: RD
authors.lastname: Sayers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014656:Vascular Surgical Procedures / Q000401:mortality*