Ann Surg Treat Res.  2016 Dec;91(6):303-308. 10.4174/astr.2016.91.6.303.

Analysis of in hospital mortality and long-term survival excluding in hospital mortality after open surgical repair of ruptured abdominal aortic aneurysm

• Gwon JG
• Kwon TW
• Cho YP
• Han YJ
• Noh MS

• KMID: 2360390
• DOI: http://doi.org/10.4174/astr.2016.91.6.303

Abstract

PURPOSE
The aim of this study was to confirm the factors that affect the mortality associated with the open surgical repair of ruptured abdominal aortic aneurysm (rAAA) and to analyze the long-term survival rates.
METHODS
A retrospective review was performed on a prospectively collected database that included 455 consecutive patients who underwent open surgical repair for AAA between January 2001 and December 2012. We divided our analysis into in-hospital and postdischarge periods and analyzed the risk factors that affected the long-term survival of rAAA patients.
RESULTS
Of the 455 patients who were initially screened, 103 were rAAA patients, and 352 were non-rAAA (nAAA) patients. In the rAAA group, 25 patients (24.2%) died in the hospital and 78 were discharged. Long-term survival was significantly better in the nAAA group (P = 0.001). The 2-, 5-, and 10-year survival rates of the rAAA patients were 87%, 73.4%, and 54.1%, respectively. Age (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.02-.08; P < 0.001) and aneurysm rupture (HR, 1.96; 95% CI, 1.12-.44; P = 0.01) significantly affected long-term survival.
CONCLUSION
Preoperative circulatory failure is the most common cause of death for in-hospital mortality of rAAA patients. After excluding patients who have died during the perioperative period, age is the only factor that affects the survival of rAAA patients.

Keyword

Aortic aneurysm; Aortic rupture

MeSH Terms

Aneurysm
Aortic Aneurysm
Aortic Aneurysm, Abdominal*
Aortic Rupture
Cause of Death
Hospital Mortality*
Humans
Mortality
Perioperative Period
Prospective Studies
Retrospective Studies
Risk Factors
Rupture
Shock
Survival Rate

Figure

• 

  Fig. 1 Comparison of the long-term survival rates of rAAA and nAAA patients analyzed in this study (not including the in-hospital mortality cases) using the Kaplan-Meier method. AAA, abdominal aortic aneurysm; rAAA, ruptured AAA; nAAA, non-rAAA.

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