Characterization of immediate and early mortality after repair of ruptured abdominal aortic aneurysm.
Characterization of immediate and early mortality after repair of ruptured abdominal aortic aneurysm.
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DOI：
10.1016/j.jvs.2022.06.090
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发表时间：
2022-12
影响因子：
4.3
通讯作者：
Liang, Nathan L.
中科院分区：
文献类型：
--
作者：
Reitz, Katherine M.;Phillips, Amanda R.;Tzeng, Edith;Makaroun, Michel S.;Leeper, Christine M.;Liang, Nathan L.
Compare immediate and early mortality among patients undergoing ruptured abdominal aortic aneurysm (RAAA) repair. Evaluation of RAAA has focused on 30-day postoperative mortality. Other emergency conditions such as trauma have demonstrated a multimodal mortality distribution within the 30-day window expanding the pathophysiologic understanding and allowing for intervention investigations with practice changing and lifesaving results. However, the temporal distribution and risk factors of postoperative morbidity and mortality in RAAA have yet to be investigated. We evaluated factors associated with RAAA postoperative mortality in immediate (<1 day) and early (1–30 days) postoperative periods in a landmarked retrospective cohort study using data from the Vascular Quality Initiative (2010–2020). We identified 5,157 RAAA repairs (mean age 72±10 years; 77% male; 88% White; 61% endovascular). The mortality rate in the immediate period was 10.2% (528/5,157) and the early mortality rate was 22.1% (918/4,163). In multivariable regression, signs of hemorrhagic shock (i.e., hemoglobin <7g/dL: aOR, 1.87 [95%CI, 1.14–3.06]; any preoperative systolic blood pressure <70mmHg: aOR, 1.40 [95%CI, 1.04–1.89]; estimated blood loss >40%: aOR, 3.65 [95%CI, 2.295.83]) were associated with increased risk of immediate mortality. Comorbid conditions (heart failure: aOR, 1.38 [95%CI, 1.00–1.92]; pulmonary disease: aOR, 1.29 [95%CI, 1.05–1.58]; elevated creatinine: aOR 1.26 [95%CI, 1.31–1.41]) were associated with increased risk of early mortality. Immediate deaths were predominantly associated with shock from massive hemorrhage, while early deaths were associated with comorbid conditions predisposing patients to multisystem organ failure despite successful repair. These temporal distinctions should guide future mechanistic and intervention evaluations to improve RAAA mortality. Retrospective, landmarked cohort study of ruptured abdominal aortic aneurysm repairs using the Vascular Quality Initiative demonstrating immediate postoperative mortality was associated with hemorrhagic shock, and early mortality with comorbid conditions predisposing patients to multisystem organ failure.
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DOI：
10.1186/s13017-016-0087-0
发表时间：
2016
期刊：
World journal of emergency surgery : WJES
影响因子：
--
作者：
Kawatani Y;Nakamura Y;Kurobe H;Suda Y;Hori T
通讯作者：
Hori T
影响因子：
168.9
作者：
Roberts, Ian;Shakur-Still, Haleema;Mutiso, Vincent
通讯作者：
Mutiso, Vincent
影响因子：
4.3
作者：
Chaikof, EL;Blankensteijn, JD;Kent, KC
通讯作者：
Kent, KC
DOI：
10.1016/j.ejvs.2005.06.013
发表时间：
2005-11-01
影响因子：
5.7
作者：
Laukontaus, SJ;Lepäntalo, M;Pettilä, V
通讯作者：
Pettilä, V
影响因子：
1.5
作者：
Adam, DJ;Haggart, PC;Bradbury, AW
通讯作者：
Bradbury, AW