Perioperative Risk Factors for Mortality in Non-infected Abdominal Aortic Aneurysm

Abstract

Background: This study assesses the surgical outcome of non-infected nonruptured abdominal aortic aneurysm (AAA) and ruptured AAA, and defines the risk factors of death. Methods: We studied 115 consecutive patients who underwent conventional operations for non-infective abdominal aortic aneurysm between July 1989 and December 2003. The 115 patients were divided into two groups according to the preoperative findings of the computed tomography (CT) scan. In group I (n=91), the patients had AAA without CT evidence of preoperative rupture of the abdominal aorta. In group Ⅱ (n=24), the patients had AAA with CT evidence of preoperative rupture of the abdominal aorta. Rupture was defined as free blood in the retroperitoneal or peritoneal space. Data were collected by retrospective chart review. Both univariate and multivariate analyses were used as risk factors for death. Results: From 1989 to 2003, 115 patients underwent operations for abdominal aortic aneurysm. The average patients age was 71.4±7.1 years (range, 40 to 87 years), and 99(86%) were male. Twenty-four patients were operated upon in ruptured state. The overall hospital mortality was 16.5%(19/115): 66.7%(16/24) in patients with ruptured abdominal aortic aneurysm and 3.3%(3/91) in patients with nonruptured abdominal aortic aneurysm. Risk factors for death were presence of rupture, preoperative shock and necessity for emergency operation. Conclusions: Mortality rates after AAA repair in our hospital were comparable with those previously reported in other series. Major determinants of surgical mortality in patients with abdominal aortic aneurysm were preoperative complications. Early diagnosis and operation before aneurysm rupture were essential for survival.