ORIGINAL ARTICLES   

Giornale Italiano di Chirurgia Vascolare 1998 December;5(4):215-26

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English, Italian

Mortality after elective surgery for abdominal aortic aneurysms. Risk factor analysis

Pulli R., Gatti M., Barbanti E., Ciccarese G., Turini F., Azas L., Alessi Innocenti A., Pratesi C.

From the Faculty of Vascular Surgery Florence University, Florence, Italy

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The aim of ­this ­study was to ana­lyse the influ­ence of var­i­ous pre­op­er­a­tive ­risk fac­tors on post­op­er­a­tive mor­tal­ity ­after elec­tive sur­gery for abdom­i­nal aor­tic aneu­rysms. It is a ret­ro­spec­tive ­study of 263 con­sec­u­tive oper­a­tions per­formed in January 1994-December 1995 ­with a ­mean fol­low-up of 28.9 ­months (range 0-44). The ­case ­series con­sist­ed of 244 elec­tive sur­gery ­patients and the prog­nos­tic param­e­ters con­sid­ered ­were: sex, age, con­com­i­tant vas­cu­lar con­di­tions and com­mon ath­e­ros­cle­rot­ic ­risk fac­tors (dia­betes, smok­ing, ­high ­blood pres­sure, dys­lip­i­dae­mia) as ­well as con­com­i­tant ischaem­ic car­di­op­a­thy, chron­ic obstruc­tive, bron­chop­neu­mop­a­thy (­COBP) or chron­ic kid­ney fail­ure and allo­ca­tion to one of the 4 ASA class­es. Univariate and mul­ti­var­i­ate regres­sion anal­y­ses was ­used to iden­ti­fy sig­nif­i­cant fac­tors in imme­di­ate mor­tal­ity and the Kaplan-Meyer meth­od was ­applied to sur­vi­val ­tables in ­order to ­assess ­long-­term ­results. Peroperative mor­tal­ity ­came to 1.2%/3 cas­es; 3-­year sur­vi­val to 86.2%. Among ­patients ­over 75 the sur­vi­val fig­ure ­fell to 76% or 77.4% in ­patients ­with ­heart dis­ease. The ­study ­found ­that mor­tal­ity ­after ­APIA sur­gery was low and 3-­year sur­vi­val sat­is­fac­to­ry, ­while the fac­tors ­with ­most ­impact on out­come ­were age and ­heart dis­ease.