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CURRENT ISSUETHE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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The Journal of Cardiovascular Surgery 1999 February;40(1):1-5

VASCULAR PAPERS 

 ORIGINAL ARTICLES

Abdominal aor­tic aneu­rysms in ­aged pati­ents: anal­y­sis of ­risk fac­tors in non-rup­tured cas­es

Sasa­ki Sh., Tak­i­ga­mi K., Kuni­ha­ra T., Shiiya N., Mura­shi­ta T., Mat­sui Y., Yasu­da K.

From the Department of Cardiovascular Surgery Hokkaido University Hospital Kita-ku, Sapporo, Japan

Background and meth­ods. A ret­ro­spec­tive anal­y­sis of 304 ­patients (274 ­males and 30 ­females) sur­gi­cal­ly treat­ed for non-rup­tured, infra­ren­al abdom­i­nal aor­tic aneu­rysm (AAA) to deter­mine the rel­a­tive con­tri­bu­tion of pre­op­er­a­tive, oper­a­tive, and post­op­er­a­tive fac­tors to mor­tal­ity and to the devel­op­ment of post­op­er­a­tive com­pli­ca­tions. 1) Risk fac­tors, hos­pi­tal mor­tal­ity and ­long-­term sur­vi­val ­rate ­were com­pared ­between ­patients ­aged 75 or old­er (­group I; n=79) and ­those ­under 75 ­years of age (group II; n=225). 2) These ­risk fac­tors ­were sub­ject­ed to uni­var­i­ate and mul­ti­var­i­ate anal­y­sis to deter­mine ­their rel­a­tive con­tri­bu­tion to ­patient hos­pi­tal mor­tal­ity and to the devel­op­ment of ­major post­op­er­a­tive com­pli­ca­tions in ­aged ­patients.
Results. Maximum diam­e­ter of AAA, the prev­a­lence of res­pir­a­to­ry dys­func­tion, dia­betes mel­lit­us and the ­total vol­umes of intra­op­er­a­tive ­blood ­loss ­were sig­nif­i­cant­ly dif­fer­ent ­between the two ­groups. A high­er hos­pi­tal mor­tal­ity was not­ed in the ­aged ­patients (10.1% ver­sus 3.1%, p<0.05). The major­ity of ­deaths in ­group I result­ed ­from ­organ dys­func­tions, espe­cial­ly ­involved ­with res­pir­a­to­ry fail­ure. The ­long ­term sur­vi­val ­rate at 3 and 5 ­years was not dif­fer­ent ­between oper­a­tive sur­vi­vors in the two ­groups. Incremental ­risk fac­tors for hos­pi­tal ­death in ­aged ­patients includ­ed the pres­ence of symp­to­mat­ic AAA, the max­i­mum diam­e­ter of AAA, the post­op­er­a­tive devel­op­ment of myo­car­dial infarc­tion, res­pir­a­to­ry com­pli­ca­tions and gas­troin­tes­ti­nal bleed­ing. Operation ­time and the vol­umes of intra­op­er­a­tive ­blood ­loss sig­nif­i­cant­ly cor­re­lat­ed ­with the post­op­er­a­tive devel­op­ment of res­pir­a­to­ry fail­ure, ­renal fail­ure and mul­ti­ple ­organ fail­ure.
Conclusions. 1) A high­er oper­a­tive mor­tal­ity and high­er prev­a­lence of post­op­er­a­tive com­pli­ca­tions ­were not­ed in ­aged ­patients ­with AAA. 2) To ­reduce oper­a­tion ­time and the vol­umes of intra­op­er­a­tive ­blood ­loss ­would be essen­tial to ­improve sur­gi­cal ­results of AAA in ­aged ­patients.

language: English


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