Determining Perioperative Mortality in Patients with Ruptured Abdominal Aortic Aneurysm: Insights from a Retrospective Cohort Study
Issued Date
2024-01-01
Resource Type
eISSN
22288082
Scopus ID
2-s2.0-85201115281
Journal Title
Siriraj Medical Journal
Volume
76
Issue
8
Start Page
480
End Page
487
Rights Holder(s)
SCOPUS
Bibliographic Citation
Siriraj Medical Journal Vol.76 No.8 (2024) , 480-487
Suggested Citation
Prapassaro T., Chinsakchai K., Techarattanaprasert S., Wongwanit C., Ruangsetakit C., Hongku K., Hahtapornsawan S., Puangpunngam N., Sermsathanasawadi N., Tongsai S., Moll F.L., Mutirangura P. Determining Perioperative Mortality in Patients with Ruptured Abdominal Aortic Aneurysm: Insights from a Retrospective Cohort Study. Siriraj Medical Journal Vol.76 No.8 (2024) , 480-487. 487. doi:10.33192/smj.v76i8.266315 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/100566
Title
Determining Perioperative Mortality in Patients with Ruptured Abdominal Aortic Aneurysm: Insights from a Retrospective Cohort Study
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Corresponding Author(s)
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Abstract
Objective: This retrospective cohort study analyzed factors determining perioperative mortality in patients with ruptured abdominal aortic aneurysm (rAAA) undergoing open surgical repair (OSR) or endovascular aneurysm repair (EVAR). Materials and Methods: 147 rAAA patients who underwent OSR (n=37) or EVAR (n=110) between 2000 and 2017 were included. Demographic data, intraoperative details, and perioperative complications were assessed. Logistic regression analysis identified factors associated with perioperative mortality. The primary endpoint was perioperative mortality rate, and the secondary endpoint focused on factors determining 30-day mortality. Results: Overall perioperative mortality was 19.04% (28/147), with 8.1% (3/37) for OSR and 22.7% (25/110) for EVAR (p=0.139). The non-survived group had more unfit patients (82.1% vs. 47.9%, p=0.002), higher preoperative serum creatinine levels (1.8±1.74 vs. 1.4±5.89, p=0.011), and higher rates of aortic balloon usage (64.3% vs. 22.7%, p<0.001) and cardiac arrest (28.6% vs. 3.4%, p<0.001). Multivariable analysis identified age >80 years (adjusted odds ratio [aOR] 9.785, p=0.003), unfit patient status (aOR 3.35, p=0.028), aortic balloon usage (aOR 5.54, p=0.036), postoperative myocardial infarction (aOR 13.995, p<0.001), postoperative congestive heart failure (aOR 15.22, p=0.038), and abdominal compartment syndrome (aOR 23.397, p<0.001) as independent predictors of 30-day mortality. Conclusion: No significant difference in perioperative mortality was found between OSR and EVAR in rAAA patients. Several independent factors predicting 30-day mortality were identified, providing valuable insights for clinicians in predicting outcomes and improving patient care in rAAA cases.