Abstract
ObjectivesTo identify the risk factors for postoperative renal dysfunction after open surgical repair (OSR) of abdominal aortic aneurysms (AAAs) and to establish a scoring system.ResultsThe overall 30-day mortality rates were 22.0%(ruptured) vs 2.6% (unruptured), respectively. For the ruptured group, the independent risk factors were hemodynamic instability (P = 0.002) blood loss >1 L (P = 0.041) and preoperative creatinine >150 μmol/L (P < 0.001). By contrast, for the unruptured group, factors were smoking (P = 0.028), blood loss >1 L (P = 0.018), and antihypertensive drugs (P < 0.001). The areas under the curve of the WCRDA scoring system are 0.794 (95% confidence interval (CI) 0.686–0.902, P < 0.001) and 0.811 (95% CI 0.691–0.932, P < 0.001) for the ruptured and unruptured groups, respectively.ConclusionsHemodynamic instability, blood loss >1 L and Hb <90 g/L are independent risk factors for postoperative renal dysfunction following rAAA OSR, whereas smoking, blood loss >1 L, and antihypertensive drugs are independent risk factors. WCRDA performs well in predicting postoperative renal dysfunction.Materials and Methods287 patients from the Vascular Department of West China Hospital, Sichuan University, who were planned to perform OSR for AAA from November 2003 to January 2017. 274 patients underwent OSR for AAA were finally included in the study. A total of 118 patients had ruptured AAA and 156 unruptured AAA.The patients were divided into the ruptured and unruptured groups. Logistic regression was used to identify the independent risk factors for postoperative renal dysfunction. The receiver operating characteristic curve was used to evaluate the scoring system.
Highlights
Despite authors [1] having reported positive results with endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA), laparotomy or open surgical repair (OSR) is still performed in many situations because not all cases of abdominal aortic aneurysms (AAAs) allow for a standard EVAR
The areas under the curve of the WCRDA scoring system are 0.794 (95% confidence interval (CI) 0.686–0.902, P < 0.001) and 0.811 for the ruptured and unruptured groups, respectively
Despite authors [1] having reported positive results with endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA), laparotomy or open surgical repair (OSR) is still performed in many situations because not all cases of AAA allow for a standard EVAR
Summary
Despite authors [1] having reported positive results with endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA), laparotomy or open surgical repair (OSR) is still performed in many situations because not all cases of AAA allow for a standard EVAR. Postoperative renal dysfunction is a significant complication leading to a high mortality rate [5]. These models only refer to the relationship between preoperative renal dysfunction and the prognosis, or postoperative renal dysfunction and the mortality. A study [6] suggest that the prevalence rates and mortality of AAA are not same in different countries or races. Another prospective multicenter study [7] has identified some risk factors for postoperative renal dysfunction. The study did not mention whether the risk factors for renal dysfunction in patients with ruptured AAA (rAAA) are the same
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