Predictors for outcome after open and endovascular repair of ruptured abdominal aortic aneurysms.
OBJECTIVE
The aims of the present study were to analyze patient- and management-related predictors for outcome after open (OR) and endovascular repair (EVAR) of ruptured abdominal aortic aneurysm (rAAA).


METHODS
Retrospective study.


METHODS
The in-hospital registry of Malmö University Hospital identified 162 patients operated on due to rAAA between 2000 and 2004.


METHODS
Patient- and management-related predictors for outcome were analysed.


RESULTS
Preoperative CT in 39 out of 62 circulatory unstable patients was not associated with increased mortality (p=0.60). There was a significant increase in repairs performed by EVAR during the study period (p<0.001), and in 2004 EVAR exceeded the annual rate of OR. Patients in the EVAR group were older (p=0.025), whereas patients in the OR group more often suffered from unconsciousness after presentation (p=0.004). Age, unconsciousness after presentation and haemoglobin were significantly associated with in-hospital mortality when tested in a multivariate logistic regression model (p=0.002, p=0.003 and p<0.001, respectively). The in-hospital mortality for patients undergoing OR and EVAR was 45% (48/106) and 34% (19/56), respectively (p=0.16). Diagnosis of abdominal compartment syndrome (p=0.005) and intestinal infarction (p=0.002) was associated with poor survival.


CONCLUSIONS
Patient-related factors such as age, loss of consciousness and haemoglobin predicts outcome in a population where both emergency OR and EVAR for the treatment of rAAA is feasible.
Acosta
S
S
Department of Vascular Diseases, Malmö University Hospital, Sweden. stefan.acosta@telia.com
Lindblad
B
B
Zdanowski
Z
Z
D000368:Aged; D000369:Aged, 80 and over; D001019:Aortic Rupture / Q000401:mortality* / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007238:Infarction / Q000453:epidemiology; D007422:Intestines / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology; D014656:Vascular Surgical Procedures