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Complications of standard elective abdominal aortic aneurysm repair
G J Akkersdijk1, Y van der Graaf, F L Moll
1Department of Surgery, University Hospital Leiden, The Netherlands.
Objective:
To evaluate complications of standard elective repair of infrarenal abdominal aortic aneurysms.
Design:
Prospective multicentre study.
Materials:
Two-hundred and ninety-one consecutive patients undergoing standard elective surgery for an infrarenal aortic aneurysm.
Methods:
Recording adverse events according to the recommendations of the Ad Hoc Committee on Reporting Standards.
Results:
Seventy-five patients (26%) experienced some complication following elective aortic aneurysm surgery. Twenty-two patients had a mild complication (7.6%, 95% C.I. 4.8-11.2%), 27 a moderate (9.3%, 95% C.I. 6.2-13.2%) and 26 patients had a severe and/or fatal complication (8.9%, 95% C.I. 5.9-12.8%). The in-hospital mortality was 4.1% (12 patients, 95% C.I. 2.2-7.1%). Cardiac failure was the commonest primary cause for death (58%). Twenty-two per cent of the patients had a non-fatal complication: the most frequent being pulmonary (10%) and cardiac (10%). Patients with a history of cardiac events had a five times higher risk of a fatal outcome (95% C.I. 1.1-24.0) and a two and a half times higher risk of any severe fatal or non-fatal complication (95% C.I. 1.0-6.5). Other risk factors were advancing age and the presence of pulmonary disease.
Conclusions:
In addition to mortality, morbidity figures of standard aneurysm operations are important, as well as associated risk factors. This is especially true when evaluating early repair of small aneurysms and new endovascular techniques.