Risk factors for predicting postoperative complications after open infrarenal abdominal aortic aneurysm repair: results from a single vascular center in China
Risk factors for predicting postoperative complications after open infrarenal abdominal aortic aneurysm repair: results from a single vascular center in China
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DOI：
10.1016/j.jclinane.2013.01.013
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发表时间：
2013-08-01
影响因子：
6.7
通讯作者：
Liu, Ke-Xuan
中科院分区：
文献类型：
--
作者：
Li, Cai;Yang, Wen-Han;Liu, Ke-Xuan
研究目的：探讨肾下型腹主动脉瘤术后并发症的危险因素，并建立预测模型。设计：回顾性分析。地点：某大学附属医院血管外科中心。测量：收集2004年1月至2010年10月中国某血管中心收治的316例腹主动脉瘤患者的临床资料。术后30d内观察并发症发生情况。主要结果：IAAA修补术患者术后并发症发生率为48.4%(153/316)，术后30d死亡率为8.8%(28/316)。术后并发症包括肺(18.9%)、心(14.2%)、肾(7.3%)、胃肠道(5.4%)、神经(1.3%)和肝(0.9%)系统，其中1.3%的病例发生急性肢体动脉栓塞。危险因素有年龄[65岁；优势比(OR)1.6]、主动脉阻断时间(>；90min；OR 2.4)、慢性阻塞性肺疾病(COPD；OR 4.4)、急诊手术(OR 6.1)和心功能不全史(OR 2.1)。结论：年龄、COPD、急诊手术、心功能不全史和主动脉阻断时间是影响IAAA手术后并发症的重要因素。(C)2013 Elsevier Inc.保留所有权利。
Study Objective: To identify the risk factors of, and develop a prediction model for, postoperative complications of patients undergoing infrarenal abdominal aortic aneurysm (IAAA) repair.Design: Retrospective analysis.Setting: Vascular surgery center of a university hospital.Measurements: The clinical data of 316 IAAA cases were collected from January 2004 to October 2010 at a single vascular center in China. Postoperative complications were observed within 30 days after surgery. Patient-specific and operation-specific characteristics were analyzed in relation to postoperative complications using multiple logistic regression analysis.Main Results: Overall incidence of postoperative complications and overall 30-day mortality of IAAA repair patients were 48.4% (153/316) and 8.8% (28/316), respectively. Postoperative complications involved pulmonary (18.9%), cardiac (14.2%), renal (7.3%), gastrointestinal (5.4%), neurologic (1.3%), and hepatic (0.9%) systems, and acute arterial embolism of the lower limb occurred in 1.3% of cases. Risk factors were age [> 65 yrs; odds ratio (OR) 1.6], aortic occlusion time (> 90 min; OR 2.4), history of chronic obstructive pulmonary disease (COPD; OR 4.4), emergency operation (OR 6.1), and history of cardiac dysfunction (OR 2.1).Conclusions: A combination of age, COPD, emergency operation, history of cardiac dysfunction and aortic occlusion time has significant impact on postoperative complications after open IAAA repair. (c) 2013 Elsevier Inc. All rights reserved.