Infrarenal Abdominal Aortic Aneurysm: Factors Influencing Survival After Operation Performed over a 25‐Year Period
Infrarenal Abdominal Aortic Aneurysm: Factors Influencing Survival After Operation Performed over a 25‐Year Period
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肾下腹主动脉瘤：25 年期间影响术后生存的因素
DOI：
10.1097/00000658-198106000-00005
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发表时间：
1981
影响因子：
9
通讯作者：
A. Silvers
中科院分区：
文献类型：
--
作者：
E. Crawford;S. A. Saleh;J. Babb;D. Glaeser;P. Vaccaro;A. Silvers
本文分析了25年来920例肾下腹主动脉瘤手术治疗的影响生存率的因素。60例患者（6.5%）发生破裂，存活率为77%，在研究期间没有变化。在860名（93.5%）接受非破裂治疗的患者中，819名（95%）手术存活。这一组的死亡率从早期的18%变化到近年的1.43%。包括心脏病、高血压和高龄在内的风险因素占30天内死亡人数的95%，然而，在研究期间，患有这些问题的患者的死亡率从19.2%降至1.9%，尽管每年接受这些风险因素治疗的患者平均人数增加了10倍。直到1971年左右，手术技术和经验的改进使死亡率下降。随后死亡率的降低更多是由于手术期间和早期恢复期麻醉、监测和其他支持措施的改善。816例（99.6%）患者获得了完整的生存信息，其中191例治疗时间超过15年，允许建立生命表进行分析。影响长期生存的因素是相关疾病和手术时的年龄。无相关心脏病或高血压患者5年、10年和15年的生存率分别为84、49和21;有心脏病的患者分别为54、34和17。患者的中位年龄为65.5岁，根据四分位数，上述时间间隔的生存率为< 60岁：71，53和24; 60岁< 71岁：66，38和18; >71岁：43，13和11。
This report is concerned with the factors influencing survival in 920 consecutive patients submitted to operation for infra-renal abdominal aortic aneurysm during the past 25 years. Rupture had occurred in 60 patients (6.5%) and survival was 77%, which did not vary during the period of study. Of the 860 patients (93.5%) treated for nonrupture, 819 (95%) survived operation. The mortality rate in this group varied from 18%, in the earlier period, to 1.43%, in recent years. Risk factors including heart disease, hypertension, and advanced age accounted for 95% of the deaths that occurred within 30 days however, the mortality rate in patients with these problems decreased from 19.2% to 1.9% during the period of study although the average number of patients treated each year with these risk factors increased tenfold. Improvements in operative techniques and experience were responsible for decreasing mortality up to about 1971. Subsequent decrease in mortality was due more to improvements in anesthesia, monitoring, and other supportive measures during operation and the early recovery period. Complete survival information was obtained in 816 (99.6%) patients, 191 of whom had been treated for periods over 15 years, permitting establishment of life tables subject to analysis. Factors influencing long-term survival were associated disease and age at time of operation. Survival in percentage in patients without associated heart disease or hypertension for 5, 10, and 15 years was 84, 49, and 21; with heart disease, it was 54, 34, and 17. The median age of patients in the scries was 65.5 years and survival at above intervals according to quartile was < 60: 71, 53, and 24; 60 < age < 71: 66, 38, and 18; >71: 43, 13, and 11.