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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES VASCULAR SECTION
The Journal of Cardiovascular Surgery 2008 Ottobre;49(5):633-7
The 30-day mortality of ruptured abdominal aortic aneurysms: influence of gender, age, diameter and comorbidities
Alexander S. 1, Bosch J. L. 2,3, Hendriks J. M. 1, Visser J. J. 1,2,3, Van Sambeek M. R. H. M. 4
1 Department of Surgery/Vascular Surgery Erasmus University Medical Center Rotterdam, The Netherlands
2 Departments of Epidemiology and Biostatistics Erasmus University Medical Center Rotterdam, The Netherlands
3 Department of Radiology Erasmus University Medical Center Rotterdam, The Netherlands
4 Department of Surgery Catharina Hospital, Eindhoven, The Netherlands
Aim. The aim of this study was to determine the influence of gender, age, the aneurysm diameter and comorbidity on the 30-day mortality after open repair of ruptured abdominal aortic aneurysms (AAA).
Methods. Between January 1, 1993, and December 31, 2006 all consecutive patients who underwent open repair for a ruptured AAA at the tertiary care of Catharina teaching Hospital were included in this study (N=186). Patients who underwent endovascular repair of their ruptured abdominal aortic aneurysms were excluded from this study. Patient and procedure characteristics were collected and analyzed in relation to 30-day mortality. The association between age, gender, diameter of AAA and comorbidity with 30-day mortality was analyzed with c2 are and logistic regression; a P value <0.05 was considered significant.
Results. In this study there were 186 patients with ruptured AAA repair with an 30-day mortality of 36.6% (68/186). Among female patient 30-day mortality was 45.8% (11/24) compared with 35.2% (57/162) among male patients (P=0.31). Patients of 80 years and older had a 61.3% (19/31) 30-day mortality where younger patients had 33% (51/155) 30-day mortality (P=0.02). Thirty-day mortality was 47.2% (17/36) for patients with an AAA less than 65 mm compared with 34% (36/104) for patients with an AAA of 65 mm or larger (P=0.16). Multivariate analysis demonstrated age was a significant predictor of ruptured AAA repair mortality (P=0.017).
Conclusion. In this study, age was the only significant risk factor of 30-day mortality after open repair in patients with ruptured AAA.