Outcome after elective infrarenal aortic aneurysm surgery

Area of Science:

• Vascular Surgery
• Surgical Outcomes Research
• Critical Care Medicine

Background:

• Elective infrarenal abdominal aortic aneurysm (AAA) repair is a significant surgical procedure.
• Understanding factors influencing postoperative morbidity and mortality is crucial for improving patient outcomes.

Purpose of the Study:

• To investigate the causes and influencing factors of morbidity and mortality in patients undergoing elective infrarenal AAA surgery.
• To identify preoperative and intraoperative predictors of complications and death.

Main Methods:

• Prospective case series of 102 consecutive patients undergoing elective infrarenal AAA surgery (1992-1995).
• Data collected on preoperative factors (demographics, risk indexes, cardiac assessments) and intraoperative factors (duration, aneurysm size, blood transfusion).
• Postoperative follow-up for 30 days, including ICU monitoring for at least 24 hours.

Main Results:

• Overall mortality rate was 4.9%, with all deaths attributed to multiorgan dysfunction syndrome (MODS).
• Preoperative blood urea nitrogen was the sole predictor of mortality (p=0.042).
• ICU complications occurred in 59% of patients, predominantly cardiovascular (83%), with surgery duration as the only significant predictor (p=0.018).

Conclusions:

• Multiorgan dysfunction syndrome (MODS), not cardiac complications, was the cause of death in this series.
• Selective preoperative screening and enhanced intraoperative/postoperative care are recommended to reduce morbidity and mortality after AAA surgery.