title: Hypothermia is associated with increased mortality in patients undergoing repair of ruptured abdominal aortic aneurysm.
abstract: OBJECTIVE
  To evaluate the impact of hypothermia on mortality in patients presenting with ruptured abdominal aortic aneurysms (rAAA).
  
  
  METHODS
  Between July 2007 and September 2009, 73 patients with ruptured AAAs presented to our Emergency Department (ED). Thirteen patients did not receive surgical treatment; of the 60 patients (46 men; mean age 76 years, range 63-90) who did, 35 had endovascular aneurysm repair (EVAR) and 25 open repair. Body temperatures, which were recorded upon arrival to the ED and operating room, during the procedure, and just prior to leaving the operating room, were analyzed for any association with mortality or hypotension. The primary outcome measure was the 30-day mortality rate.
  
  
  RESULTS
  Six (17%) patients in the EVAR group and 10 (40%) patients in the open group died during the 30-day period. Temperature upon arrival to OR, lowest temperature recorded during the procedure, and temperature at the end of the procedure were higher among survivors (p<0.005), independent of the repair technique implemented. Patients in the EVAR group left the OR with a mean temperature of 35.5 degrees C versus 35.0 degrees C for patients in the open group (p = 0.12).
  
  
  CONCLUSIONS
  Hypothermia is associated with increased mortality after repair of rAAA. Efforts to correct hypothermia are more frequently successful in patients undergoing EVAR. Increased communication with anesthesia providers, as well as aggressive measures to correct hypothermia, including active intravascular rewarming methods, should be considered to improve mortality in this gravely ill patient population.
authors.affiliation: Division of Vascular Surgery, University of Washington, Seattle, Washington 98104, USA.
authors.forename: Elina
authors.initials: E
authors.lastname: Quiroga
authors.forename: Nam T
authors.initials: NT
authors.lastname: Tran
authors.forename: Thomas
authors.initials: T
authors.lastname: Hatsukami
authors.forename: Benjamin W
authors.initials: BW
authors.lastname: Starnes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality* / Q000601:surgery*; D001019:Aortic Rupture / Q000401:mortality* / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007035:Hypothermia / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014861:Washington