title: Intra-abdominal aortic graft infection: prognostic factors associated with in-hospital mortality.
abstract: BACKGROUND
  Mortality associated with aortic graft infection is considerable. The gold standard for surgical treatment remains explantation of the graft. However, prognostic factors associated with early mortality due to this surgical procedure are not well-known.
  
  
  METHODS
  Retrospective analysis of patients admitted in our center between January 2006 and October 2011 for aortic graft infection. The primary endpoint was in-hospital mortality. A bivariate analysis of characteristics of patients associated with in-hospital outcome was performed.
  
  
  RESULTS
  Twenty five evaluable patients were studied. All patients were male. Their mean age was 67 ± 8.4 years. Most of them (92%) had severe underlying diseases. An in situ prosthetic graft replacement, mainly using cryopreserved arterial allografts, was performed in all patients, excepted one who underwent extra-anatomic bypass. Causative organisms were identified in 23 patients (92%). The in-hospital mortality rate was 48%. Among pre-operative characteristics, age ≥ 70 years, creatinine ≥ 12 mg/L and C reactive protein ≥ 50 mg/L were significantly associated with in-hospital mortality. Hospital mortality rates increased with the number of risk factor present on ICU admission, and were 0%, 14.3%, 85.7% and 100% for 0, 1, 2 and 3 factors, respectively. The only intra-operative factor associated with prognosis was an associated intestinal procedure due to aorto-enteric fistula. SAPS II, SOFA score and occurrence of medical or surgical complications were postoperative characteristics associated with in-hospital mortality.
  
  
  CONCLUSIONS
  Morbidity and mortality associated with surgical approach of aortic graft infections are considerable. Age and values of creatinine and C Reactive protein on hospital admission appear as the most important determinant of in hospital mortality. They could be taken into account for guiding the surgical strategy.
authors.forename: Matthias
authors.initials: M
authors.lastname: Garot
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Delannoy
authors.forename: Agnès
authors.initials: A
authors.lastname: Meybeck
authors.forename: Béatrice
authors.initials: B
authors.lastname: Sarraz-Bournet
authors.forename: PierVito
authors.initials: P
authors.lastname: d'Elia
authors.forename: Thibaud
authors.initials: T
authors.lastname: d'Escrivan
authors.forename: Patrick
authors.initials: P
authors.lastname: Devos
authors.affiliation: Service de Réanimation Médicale et Maladies Infectieuses, Hôpital Chatiliez, Rue du Président Coty, Tourcoing 59208, France. oleroy@ch-tourcoing.fr.
authors.forename: Olivier
authors.initials: O
authors.lastname: Leroy
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D016905:Gram-Negative Bacterial Infections / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D016908:Gram-Positive Bacterial Infections / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
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