Vasc Spec Int.  2018 Jun;34(2):19-25. 10.5758/vsi.2018.34.2.19.

Treatment Outcomes and Risk Factors for In-Hospital Mortality in Patients with Acute Aortic Occlusion

• Na DH
• Hwang D
• Park S
• Kim HK
• Huh S

• KMID: 2416376
• DOI: http://doi.org/10.5758/vsi.2018.34.2.19

Abstract

PURPOSE
The aims of the present study are to determine the outcomes after acute aortic occlusion (AAO) and analyze the risk factors for in-hospital mortality.
MATERIALS AND METHODS
We retrospectively analyzed 24 patients who were diagnosed with AAO from 2002 to 2017 in our registered data. Demographic and radiologic characteristics of AAOs were retrospectively collected. Perioperative treatment outcomes including in-hospital mortality were also assessed and the risk factors of in-hospital mortality were analyzed.
RESULTS
The median symptom duration was 21 hours. Five patients had complete paraplegia and 10 patients (41.7%) were initially evaluated for central nervous system disorders instead of acute arterial occlusion. The etiology was determined to be aortoiliac thrombosis in 17 patients (70.8%) and embolic occlusion in 7. Surgical revascularization was performed in 23 patients, and one patient did not receive any treatment. The overall in-hospital mortality was 34.8% (8/23) and 30-day mortality was 26.1%. In the univariate analysis, age (P=0.040), preoperative renal insufficiency (serum creatinine over 1.5 mg/dL at the time of presentation) (P=0.008), postoperative acute kidney injury (need for dialysis or an increase in serum creatinine of >50.0% within 48 hours) (P=0.006), combined external iliac artery occlusion (P=0.019) and combined bilateral internal iliac artery occlusion (P=0.039) were associated with in-hospital mortality.
CONCLUSION
A substantial number of AAO patients were initially evaluated for a central nervous system lesion, which led to a delay in diagnosis. Thus, vascular examinations should always be performed in every patient presenting with lower limb neurologic deficits. Age, perioperative renal function, and combined iliac artery occlusion were associated with the prognosis of AAOs.

Keyword

Abdominal aorta; Thrombosis; Embolism; Mortality; Risk factors

MeSH Terms

Acute Kidney Injury
Aorta, Abdominal
Central Nervous System
Central Nervous System Diseases
Creatinine
Diagnosis
Dialysis
Embolism
Hospital Mortality*
Humans
Iliac Artery
Lower Extremity
Mortality
Neurologic Manifestations
Paraplegia
Prognosis
Renal Insufficiency
Retrospective Studies
Risk Factors*
Thrombosis
Creatinine