Characteristics and Prognosis of Abdominal or Thoracic Aortic Aneurysm Patients Admitted to Intensive Care Units After Surgical Treatment: A Multicenter Retrospective Observational Study

Abstract

Objective To investigate the characteristics and prognosis of abdominal or thoracic aortic aneurysm (AAA or TAA) patients admitted to intensive care unit (ICU) postoperatively. Methods Patients admitted to ICU postoperatively with a primary diagnosis of AAA or TAA were screened in the eICU Collaborative Research Database, which contained data from multiple ICUs throughout the continental United States in 2014 and 2015. Baseline characteristics and comorbidities and were investigated and factors associated with ICU mortality were explored using univariable logistic regression. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the prognosis predictive performance of the widely used severity scoring system APACHE IVa. Results A total of 974 patients including 677 AAA and 297 TAA patients admitted to ICU postoperatively were included. Compared with TAA, AAA patients had a significantly higher median age (72 versus 64 years, P<0.001). 89.07% AAA and 84.51% TAA patients underwent elective surgery (P=0.046), 8.71% AAA and 31.99% TAA patients were with aortic dissection (P<0.001), and 10.19% AAA and 2.36% TAA patients suffered from rupture of aortic aneurysm (P<0.001). Hypertension requiring treatment was the most common comorbidity (57.31% for AAA and 61.95% for TAA). TAA patients had significantly higher ICU mortality (9.43% versus 2.36%, P<0.001) than AAA. Several factors were found to be significantly associated with ICU mortality, including urgent surgery, with aortic dissection, rupture of aortic aneurysm, TAA, and a higher APACHE IVa score on ICU admission. APACHE IVa showed a good predictive performance for ICU mortality with an area under the ROC curve of 0.9176 (95% CI 0.8789–0.9390). Conclusion The prognosis of aortic aneurysm patients admitted to ICU postoperatively is yet to improve, and factors associated with prognosis are mainly related to the condition itself. APACHE IVa can be used for prognosis prediction.

Prevalence and mortality rate of arterial aneurysm and dissection in yazd, iran; a cross-sectional study between 2011 and 2017

“…In contrast, in another study conducted by Nicolini et al the mortality of aortic aneurysm was significantly higher in women than in men (17). In the study by Chen et al, the frequency of CAD was similar to the current research in patients with arterial aneurysms (14). In Wang et al's study, CAD and hypertension were identified as the primary risk factors for aortic aneurysm, aligning with the present study (8).…”

“…Nonetheless, akin to Chen et al's study, the highest frequency was linked to abdominal aortic aneurysms. Chen et al's study also indicated that mortality rates differed based on the location of the aortic aneurysm (14). In the present study, the frequency of men surpassed that of women.…”

Cardiovascular Particularities in Pega Breed Donkeys (Equus asinus)

“…In our study, animals over six years old presented higher measurements in aortic and pulmonary diameters. In humans, the aortic diameter may increase with age, and collagen changes and systemic arterial hypertension may contribute to aortic artery aneurysm (Kobeissi et al 2019;Chen et al 2021).…”

Development of SAB model for predicting mortality in intensive care unit after aortic aneurysm surgery

“…5% of AA patients with multiorgan failure died before hospital discharge, which had higher incidence than the patients without organ dysfunction (23). The ICUmortality of AAA patients was 2.36%, while TAA patients had the incidence of 9.43% (24). When patients are in unstable situation after surgery, surgeons will routinely transfer them to ICU.…”