Changes in laboratory values and their relationship with time after rupture of an abdominal aortic aneurysm.
OBJECTIVE
Many laboratory values are abnormal after surgery for a ruptured abdominal aortic aneurysm (RAAA). However, these changes have not been comprehensively evaluated. We analyzed the changes in routine laboratory values and how these changes related to outcome in a consecutive series of RAAA patients.


METHODS
All patients who underwent surgery for an RAAA between January 1990 and June 2003 at our hospital were included in this study. We analyzed laboratory data acquired during the first week for all patients and at discharge for survivors. We categorized 29 different measurements into six categories based on the related pathological process, including hematology and coagulation, metabolism, systemic inflammation, renal function, liver function, and electrolytes.


RESULTS
A total of 290 patients underwent RAAA surgery, with a hospital mortality of 34%. Hemorrhage was the most common cause of early death, whereas multiple-organ failure (MOF) was the most common cause of death several days after surgery. Most laboratory values deviated from normal at multiple time points and they differed significantly between survivors and nonsurvivors.


CONCLUSIONS
Both survivors and nonsurvivors of RAAA surgery displayed characteristic time-dependent laboratory abnormalities. Awareness of these responses may help us predict patients prone to complications.
Haveman
Jan W
JW
Department of Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands.
Zeebregts
Clark J
CJ
Verhoeven
Eric L G
EL
van den Berg
P
P
van den Dungen
Jan J A M
JJ
Zwaveling
Jan H
JH
Nijsten
Maarten W N
MW
D000368:Aged; D017542:Aneurysm, Ruptured / Q000097:blood* / Q000401:mortality; D017544:Aortic Aneurysm, Abdominal / Q000097:blood* / Q000401:mortality; D002097:C-Reactive Protein / Q000032:analysis; D002423:Cause of Death; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012016:Reference Values; D013997:Time Factors
D002097:C-Reactive Protein