[Postoperative complications and mortality in abdominal aortic aneurysm surgery]

To analyze morbidity and mortality in patients undergoing surgery for aneurysm of the abdominal aorta, in order to identify risk factors.

We conducted a retrospective study of 143 patients with aortic aneurysm undergoing surgery between January 1986 and April 1993. One hundred twenty-seven aneurysms were infrarenal and 16 were adjacent to the kidney.

Surgery was scheduled in 67.1% of the cases, emergency in 27.2% and deferred in 5.59%. The mortality for each of these groups was 8.3%, 33.3% and 62.5%, respectively. Exitus took place within the first 24 hours after admission. Secondary diseases, usually ischemic cardiopathy, were present in 68.5%. The most frequently observed postoperative complications were cardiovascular, followed by renal, respiratory and digestive problems. The most frequent cause of death was acute myocardial infarction, followed by hypovolemic shock in emergency patients. Factors representing significant risk of mortality were age over 80 years (p < 0.001), aneurysmatic rupture (p < 0.001) and blood loss requiring transfusion of more than 4 units of packed red cells during surgery (p < 0.001).

The increase in the number of elective procedures (including scheduled resection of small aneurysms), early diagnosis and treatment of ruptures and aggressive hemodynamic management in the perioperative period--with special attention to cardiovascular status in the first 24 hours after surgery--are all factors that can contribute to better outcome.