title: Risk Factors for Survival following Open Surgical Repair of Ruptured Abdominal Aortic Aneurysms: A 13-Year Experience.
abstract: BACKGROUND
  Surgical treatment of a ruptured abdominal aorta aneurysm (RAAA) continues to present a significant challenge to surgeons. There are some patient factors such as age and gender that cannot be changed, and comorbid conditions can be optimized but not eliminated. The purpose of this study was to identify the risk factors affecting high mortality after the surgical repair of an RAAA.
  
  
  METHODS
  Data on 121 patients who underwent surgical repair for RAAAs between January 1997 and June 2011 in our institution were collected retrospectively. All the patients had been diagnosed by computed tomography (CT) scans, and intraoperative extra-luminal blood was visualized intraoperatively. Variables studied comprised demographic data; preoperative, operative, and postoperative data; and the causes of mortality. Multivariate regression analysis was used to determine the predictors of mortality.
  
  
  RESULTS
  One hundred eight (89.2%) patients were male and 13 (10.7%) were female at an average age of 68.9 ± 10.5 years. Totally, 121 patients underwent surgery for RAAAs. Fifty-four patients had aortic tube grafts, 32 aortobiiliac grafts, 20 aortobifemoral grafts, 1 aortoiliac graft, and 1 aortofemoral graft for the replacement of the RAAAs. Seven patients had only surgical exploration. Operative mortality was 41.3% (50 patients). The factors associated with mortality were preoperative shock, free blood, positive inotropic agent, hematocrit value, and need for blood and plasma. In the multivariate analysis, preoperative shock and positive inotropic agents were found to be significant as the predictors of death (OR: 19.8, 95%CI: 3.2-122.8 and OR: 8.6, 95% CI: 2.9-26.3, respectively).
  
  
  CONCLUSIONS
  This study revealed that the preoperative clinical findings affected the mortality associated with RAAAs.
authors.affiliation: Türkiye Yüksek Ihtisas Hospital, Cardiovascular Surgery Department, Ankara, Turkey.
authors.forename: Anil
authors.initials: A
authors.lastname: Ozen
authors.affiliation: Türkiye Yüksek Ihtisas Hospital, Cardiovascular Surgery Department, Ankara, Turkey.
authors.forename: Muhammet Onur
authors.initials: MO
authors.lastname: Hanedan
authors.affiliation: Türkiye Yüksek Ihtisas Hospital, Cardiovascular Surgery Department, Ankara, Turkey.
authors.forename: Çetin Murat
authors.initials: ÇM
authors.lastname: Songur
authors.affiliation: Türkiye Yüksek Ihtisas Hospital, Cardiovascular Surgery Department, Ankara, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Boysan
authors.affiliation: Türkiye Yüksek Ihtisas Hospital, Cardiovascular Surgery Department, Ankara, Turkey.
authors.forename: Ertekin Utku
authors.initials: EU
authors.lastname: Unal
authors.affiliation: Türkiye Yüksek Ihtisas Hospital, Cardiovascular Surgery Department, Ankara, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Mola
authors.affiliation: Türkiye Yüksek Ihtisas Hospital, Cardiovascular Surgery Department, Ankara, Turkey.
authors.forename: Halil Ibrahim
authors.initials: HI
authors.lastname: Erkengel
authors.affiliation: Türkiye Yüksek Ihtisas Hospital, Cardiovascular Surgery Department, Ankara, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Kubat
authors.affiliation: Türkiye Yüksek Ihtisas Hospital, Cardiovascular Surgery Department, Ankara, Turkey.
authors.forename: Zafer
authors.initials: Z
authors.lastname: Iscan
authors.affiliation: Türkiye Yüksek Ihtisas Hospital, Cardiovascular Surgery Department, Ankara, Turkey.
authors.forename: Ufuk
authors.initials: U
authors.lastname: Tutun
authors.affiliation: Türkiye Yüksek Ihtisas Hospital, Cardiovascular Surgery Department, Ankara, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Sarıtas
authors.affiliation: Türkiye Yüksek Ihtisas Hospital, Cardiovascular Surgery Department, Ankara, Turkey.
authors.forename: Cemal Levent
authors.initials: CL
authors.lastname: Birincioglu
keywords: Aortic aneurysm; Cardiac surgical procedures; Mortality; abdominal