Prediction of survival after 48-h of intensive care following open surgical repair of ruptured abdominal aortic aneurysm.
OBJECTIVE
To identify predictive factors for 30-day mortality after 48 h of maximal treatment in intensive care unit (ICU) after repair for ruptured abdominal aortic aneurysm (RAAA).


METHODS
Retrospective study in the ICU of the university central hospital.


METHODS
Between 1999 and 2003, a total of 197 patients were admitted to emergency unit due to RAAA, and 185 of them underwent open surgical repair. A total of 138 patients survived at least 48-h and were included in a study to identify factors predictive of 30-day mortality by logistic regression analysis.


RESULTS
Thirty-day mortality of all RAAA patients was 46% (87/197) whereas the 30-day mortality for those alive at 48 h was 22% (31/138). Forward stepwise multivariate logistic regression analysis revealed that only organ dysfunction by SOFA score (sequential organ failure assessment) at 48-h, preoperative Glasgow Aneurysm Score, and supra-renal clamping in operation were independent predictors of death.


CONCLUSIONS
Degree of organ dysfunction by SOFA score was the best predictor of 30-day mortality in RAAA patients alive at 48-h after open surgical repair.
Laukontaus
S J
SJ
Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland. sani.laukontaus@hus.fi
Lepäntalo
M
M
Hynninen
M
M
Kantonen
I
I
Pettilä
V
V
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality* / Q000601:surgery*; D001019:Aortic Rupture / Q000401:mortality* / Q000601:surgery*; D003422:Critical Care; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000401:mortality; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012077:Renal Artery / Q000601:surgery; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016019:Survival Analysis