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Operative mortality rates after elective infrarenal aortic reconstructions
T S Huber1, T R Harward, T C Flynn
1Department of Surgery, University of Florida College of Medicine, Gainesville 32610-0286, USA.
Journal of Vascular Surgery
|September 1, 1995
Summary
Multisystem organ failure (MSOF), not cardiac events, is the primary cause of death following elective aortic reconstructions. Increased procedure complexity and patient comorbidities elevate the risk of MSOF and operative mortality.
Area of Science:
- Vascular Surgery
- Surgical Outcomes
- Critical Care Medicine
Background:
- Cardiac complications were historically the leading cause of mortality after aortic reconstructions.
- Advances in perioperative care may have altered the primary causes of death.
Purpose of the Study:
- To test the hypothesis that cardiac complications are no longer the leading cause of death after elective aortic reconstructions.
- To identify the primary causes of perioperative mortality in contemporary aortic reconstruction.
Main Methods:
- Retrospective review of 722 elective infrarenal aortic reconstructions (1982-1994).
- Analysis of perioperative deaths to determine causes.
- Comparison with survivors to identify risk factors.
Main Results:
- Overall mortality rate was 6.1% (44 deaths).
- Multisystem organ failure (MSOF) caused 56.8% of deaths, followed by cardiac events (25%).
- Visceral organ dysfunction and pneumonia were common MSOF causes; age, comorbidities, and procedure complexity increased mortality.
Conclusions:
- MSOF, particularly from visceral organ dysfunction, is the leading cause of death after elective infrarenal aortic reconstruction.
- Operative mortality risk is associated with procedural complexity and patient comorbidities.