J Korean Soc Vasc Surg.  2000 Nov;16(2):195-205.

The Analysis of Operative Mortality for Patients Requiring Arterial Surgery

• Do JY
• Huh S
• Kim YW

Abstract

PURPOSE: The purpose of this study is to investigate the frequencies and causes of operative mortalities in patients who underwent arterial operations for various arterial diseases. METHOD: The preregistered data base of 604 patients (533 men and 71 women, mean age 65 11.9 years ranging 10~88 years) who underwent arterial operations at Department of Surgery, Kyungpook National University Hospital was retrospectively reviewed. Operative mortality included patient death within 30 days after operation or during the same admission period. Frequencies and their causes of operative mortality were analyzed according to the arterial disease, location of the arterial lesion, surgical procedure, timing of their occurrence and associated risk factors. RESULT: Patients with arterial disease comprised of 399 chronic occlusive, 126 acute occlusive and 79 aneurysmal disease. Overall operative mortality rate was 4.5% including 0.8% with chronic arterial occlusive disease, 7.6% with aneurysmal disease, and 14.3% with acute arterial occlusive disease. In the chronic occlusive disease, there was no statistically significant differences in the operative mortality rates by the location of disease, surgical procedures, age or other associated risk factors. Cause of operative mortality in this group was all cardiac origin. Operative mortality rates in the patients with acute arterial occlusive disease were 40% and 10.8% in mesenteric and limb artery occlusive disease respectively, and 16.2% and 11.5% in acute embolism and acute thrombosis, respectively. Preoperative renal dysfunction (serum creatinine> or =1.5 mg/dL) was an independent risk factor for operative mortality in acute arterial occlusive disease (80% vs 11.6% in embolism, p=0.002, 100% vs 8% in thrombosis, p=0.011). The main causes of death were organ failure (55.6%) and cardiac (33.3%). In aneurysmal disease, all mortalities occurred in ruptured aneurysm. Operative mortality rate of ruptured abdominal aortic aneurysm was 20.8%. The main causes of death were exanguination (50%) and later development of organ failure(50%). CONCLLUSION: To reduce operative mortalities after arterial surgery, disease-specific and surgery-specific causes of death should be considered.

Keyword

Arterial surgery; Operative mortality

MeSH Terms

Aneurysm
Aneurysm, Ruptured
Aortic Aneurysm, Abdominal
Arterial Occlusive Diseases
Arteries
Cause of Death
Embolism
Extremities
Female
Gyeongsangbuk-do
Humans
Male
Mortality*
Retrospective Studies
Risk Factors
Thrombosis