Abstract
Thoracoabdominal aortic aneurysm (TAAA) repair is related to a relevant morbidity and in-hospital mortality rate. In this retrospective observational single-center study including serum zinc levels of 33 patients we investigated the relationship between zinc and patients’ outcome following TAAA repair. Six patients died during the hospital stay (18%). These patients showed significantly decreased zinc levels before the intervention (zinc levels before intervention: 60.09 µg/dl [survivors] vs. 45.92 µg/dl [non-survivors]). The post-interventional intensive care SOFA-score (Sepsis-related organ failure assessment) (at day 2) as well as the SAPS (Simplified Acute Physiology Score) (at day 2) showed higher score points in case of low pre-interventional zinc levels. No significant correlation between patient comorbidities and zinc level before intervention, except for peripheral arterial disease (PAD), which was significantly correlated to reduced baseline zinc levels, was observed. Septic shock, pneumonia and urinary tract infections were not associated to reduced zinc levels preoperatively as well as during therapy. Patients with adverse outcome after TAAA repair showed reduced pre-interventional zinc levels. We speculate that decreased zinc levels before intervention may be related to a poorer outcome because of poorer physical status as well as negatively altered perioperative inflammatory response.
Highlights
We demonstrate that patients with higher zinc levels after intervention tended to have lower C-reactive protein (CRP) values on day 2 (Supplementary Fig. S4C; p = 0.0642)
We hypothesize that patients who enter treatment with already markedly decreased zinc levels suffer from worse zinc deficiency in the peripheral blood due to acute phase reaction during therapy leading to increased patient mortality
Zinc deficiency represents a potential phenomenon of chronic inflammation especially in patients with severe atherosclerosis, which is a common comorbidity of Thoracoabdominal aortic aneurysm (TAAA) patients
Summary
In this retrospective observational study 33 patients suffering from TAAA requiring treatment because of a diameter above 5.5 cm or in case of connective-tissue disease, above 5.0 cm. Patients were included between the 11th of January and the 20th of December 2017. All patients were treated at the RWTH Aachen University Hospital. Patients that underwent an open or endovascular TAAA repair wereevaluated. Exclusion criteria were the following: age below 18 years, pregnancy, patients with immunosuppressive medication and patients with pre-existing need for renal replacement therapy.
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