Factors that affect the survival rate of patients with ruptured abdominal aortic aneurysms

Halpern, Vivienne J.; Kline, Roxana G.; D’Angelo, Anthony J.; Cohen, Jon R.

doi:10.1016/s0741-5214(97)70005-3

Cited by 96 publications

(73 citation statements)

References 30 publications

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“…Rather than using predictive variables to identify patients who will not survive, several studies, including this study, have been conducted to determine the surgical tactics and anesthesiological procedures that can improve the survival rate and identify patients in whom preoperative conditions and other clinical factors make conventional surgical repair inopportune. Although several authors noted higher mortality rates among elderly patients, 6,25,28,29) advanced age was not found to be a significant predictor of survival in this study. Once elderly patients have survived the operation, they can enjoy a long life expectancy, similar to their contemporaries in the general population.…”

Section: Figcontrasting

confidence: 77%

Indicators of Survival after Open Repair of Ruptured Abdominal Aortic Aneurysms and an Index for Predicting Aneurysmal Rupture Potential

Takahashi

Fukui

Wada

et al. 2011

Annals of Vascular Diseases

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Introduction Despite the increased number of cases of elective abdominal aortic aneurysm (EAAA) repair, the number of patients with ruptured AAA (RAAA) has not significantly reduced in the past decade.1) Further, although the mortality rate following EAAA repair has steadily improved by about 1%-6%, 2) the mortality rate after RAAA repair has not significantly changed in the last three decades and is still in the 30%-70% range. 3, 4) Many factors, including age, comorbidity, medical condition, preoperative shock or hypotension, increased creatinine level, low hemoglobin or hematocrit level, and technical and postoperative complications, are considered predictors of death, but none of these correctly predict the outcome of patients with RAAA. 5-7)The maximum transverse aneurysmal diameter has been the only criterion used to predict aneurysmal rupture potential in the last 40 years.8) According to this criterion, aneurysms reaching 5-5.5 cm in diameter are generally recommended for repair. 9) However, there are many reports of rupture of aneurysms smaller than 5.5 cm in diameter; the estimated rupture rate of small aneurysms varies between 4.6% and 23%.10) On the other hand, the incidental presentation of extremely large asymptom- Results: The mortality rate was 18.6% (8/43). The ratio between the maximum aneurysmal diameter and the length (along the central axis) from the aneurysmal neck to the point at which the diameter was threefourth of the maximum aneurysmal diameter was used as an index to predict aneurysmal rupture potential. The index score was 2.7 ± 1.2 in the RAAA and 1.9 ± 0.9 in the EAAA (p = 0.018). For aneurysms of ≤ 6-cm diameter, the index score was 3.0 ± 1.0 in the RAAA and 1.8 ± 0.9 in the EAAA (p = 0.03). All patients in the EAAA except one had an index score of < 2.3 and 6 of the 7 patients with RAAA had a score of > 3. Indicators of Survival after Open Repair of Ruptured Conclusions:The results suggest that patients with AAA having scores of > 3 are at high risk of rupture. This index would be useful for decision making regarding repair of AAA, especially in the borderline cases.

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Section: Figcontrasting

confidence: 77%

Indicators of Survival after Open Repair of Ruptured Abdominal Aortic Aneurysms and an Index for Predicting Aneurysmal Rupture Potential

Takahashi

Fukui

Wada

et al. 2011

Annals of Vascular Diseases

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“…Diğer bazı çalışmalarda ise hastada ameliyat öncesi düşük tansiyon, düşük hemoglobin seviyeleri varlığı ve kreatinin düzeyinin >1.5 mg/dl olmasının ameliyat sonrası yüksek mortalite ile ilşikili olduğu saptanmıştır. [8,9] Abdominal aort anevrizmalarının etyolojisinde sigara kullanımı, hipertansiyon, ateroskleroz, aile öyküsü, erkek cinsiyet gibi nedenler yer almaktadır. [10] Bizim çalışma grubumuzda da hipertansiyon, hiperlipidemi, diyabetes mellitus (DM), sigara kullanımı, serum kreatinin yüksekliği (>1.5 mg/dl) ve kronik tıkayıcı akciğer hastalığı eşlik eden hastalıklar olarak saptandı.…”

Section: Discussionunclassified

Emergency surgical treatment of a ruptured abdominal aortic aneurysm: a 10-year experience in diagnosis and treatment

Halıcı¹

2014

Turk Gogus Kalp Dama

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Amaç: Bu çalışmada, rüptüre abdominal aort anevrizmasında gerçekleştirilen acil ameliyatlara ilişkin sonuçlar bildirildi.Ça lış m apla nı:Şubat 2001 -Şubat 2011 tarihleri arasında acil servise başvuran ve rüptüre abdominal aort anevrizması nedeni ile acil ameliyata alınan 20 hasta (1 kadın, 19 erkek, ort. yaş 64.9±9.4 yıl; dağılım 50-77 yıl) retrospektif olarak incelendi. Hastaların birine (%5) kombine sol torakotomi + median laparotomi yapılırken, diğerlerine sadece median laporotomi yapıl-dı. Heparinizasyon sonrasında aorta kros klemp uygulandı. Kros klemp uygulanamayan hastalarda (n=3) endoklemp olarak Foley sonda ile oklüzyon sağlanmak suretiyle proksimal kanama kontrolü yapıldı. Hastaların altısına (%30) anevrizmektomi + aortobifemoral baypas, 10'una (%50) anevrizmektomi + aortobiiliyak baypas, ikisine (%10) anevrizmektomi + abdominal aorta greft interpozisyonu, birine (%5) eksploratif laparatomi ve birine (%5) toraks + batın eksplorasyonu yapıldı. Ameliyatta kullanılan greft materyalleri politetrafloretilen (PTFE) pantolon greft (%80) ve Dacron tüp greft (%10) idi. Bul gu lar:Ameliyat sonrası erken dönemde bir hastada (%5) iskemik kolit, dört hastada (%20) uzamış entübasyon (>72 saat), bir hastada (%5) yara yeri enfeksiyonu, iki hastada (%10) aritmi ve bir hastada (%5) dissemine intravasküler koagülasyon gözlendi. Hastaların yoğun bakım ünitesinde ve hastanede kalış süreleri sırasıyla, 3.8±2.1 gün ve 8.5±3.4 gün olarak saptandı. Toplam dört hastada (%20) mortalite gözlendi.So nuç:Rüptüre abdominal aort anevrizması varlığının erken tanısı-nın ve aorta kros klemp için uygun olmayan hastalarda Foley sonda ile endoklemp veya intraaortik balon oklüzyonu uygulamasının acil ameliyatın başarısını artırabileceğini düşünmekteyiz.Anah tar söz cük ler: Karın ağrısı; acil ameliyat; rüptüre abdominal aort anevrizması.Background: This study aims to report the results of emergency operations of ruptured abdominal aortic aneurysm.

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“…Wartość ta nie odbiega znacząco od danych z piśmiennictwa [6,7] oraz wyników dużych badań publikowanych w ostatnich latach [8,9,10]. W badaniu z Mayo Clinic (USA), gdzie do analizy włączono 413 chorych wyniosła ona 45% [8].…”

Section: Dyskusjaunclassified

“…Inni autorzy stwierdzają, że wiek nie jest czynnikiem ryzyka [6,10]. Udowodniono, że osiemdziesięciolatkowie, którzy przeżyją zabieg operacyjny, mogą spodziewać się podobnej długości życia jak chorzy bez RAAA w tej grupie wiekowej [12,13].…”

Section: Dyskusjaunclassified

Okołooperacyjne czynniki prognostyczne u chorych z pękniętym tętniakiem aorty brzusznej leczonych na oddziale intensywnej terapii

Gierek

Cyzowski

Kaczmarska

et al. 2013

Anaesthesiol Intensive Ther

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Background. The incidence of abdominal aortic aneurysm has been estimated at 20-40 cases per 100,000 per annum. The disease is often asymptomatic; in many cases, its first symptom is shock caused by a ruptured aneurysm. The aim of the present study was to assess retrospectively the selected perioperative factors in patients hospitalised in the intensive care unit (ICU) after repair of ruptured abdominal aortic aneurysm. Methods. Analysis involved medical records of patients after repair of ruptured abdominal aortic aneurysm treated in ICU in the years 2009-2010. Patients were divided into two groups: group I -survivors who were discharged from ICU and group II -non-survivors. Demographic factors, intraoperative data, vital parameters, laboratory results and severity of patient's state on admission to ICU were analysed. Results. Analysis of laboratory results on admission to ICU showed lower values of pH and HCO 3 -concentrations

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Factors that affect the survival rate of patients with ruptured abdominal aortic aneurysms

Cited by 96 publications

References 30 publications

Indicators of Survival after Open Repair of Ruptured Abdominal Aortic Aneurysms and an Index for Predicting Aneurysmal Rupture Potential

Indicators of Survival after Open Repair of Ruptured Abdominal Aortic Aneurysms and an Index for Predicting Aneurysmal Rupture Potential

Emergency surgical treatment of a ruptured abdominal aortic aneurysm: a 10-year experience in diagnosis and treatment

Okołooperacyjne czynniki prognostyczne u chorych z pękniętym tętniakiem aorty brzusznej leczonych na oddziale intensywnej terapii

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