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PROGNOSTIC FACTORS IN ELECTIVE AORTIC RECONSTRUCTIVE SURGERY
Author(s) -
Holland A. J. A.,
Bell R.,
Ibach E. G.,
Parsons R. W.,
Vu H. T. V.,
House A. K.
Publication year - 1998
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1998.tb04629.x
Subject(s) - medicine , odds ratio , hazard ratio , dialysis , blood transfusion , perioperative , surgery , retrospective cohort study , heart failure , confidence interval
Background : The present study was carried out to determine the risk factors associated with peri‐operative mortality and long‐term survival in patients undergoing abdominal aortic reconstructive surgery (ARS). Methods : A retrospective review was performed of the case notes of all patients having ARS at a university teaching hospital during a 5.5‐year period, and their details entered onto a pro forma. Results : A total of 252 patients underwent ARS between July 1989 and December 1994. The peri‐operative mortality was 7.5%. The most frequent adverse events were cardiac events, accounting for 8 (42%) of the peri‐operative deaths. The risk of a peri‐operative cerebrovascular accident was low (n = 3, 1.2%) as was the risk of peri‐operative renal failure requiring dialysis (n = 3, 1.2%). Factors independently linked to increased peri‐operative mortality included moderate‐to‐severe hypertension ( P = 0.05, odds ratio = 3.54), those with renal impairment ( P = 0.05, odds ratio = 2.69), and blood transfusion requirements ( P < 0.001, odds ratio = 1.26). Long‐term survival was independently shortened by occlusive disease ( P = 0.004, hazard ratio = 2.78) and ischaemic heart disease ( P < 0.001, hazard ratio = 3.58). Conclusions : The risks of ARS were significantly increased in patients with severe hypertension, those with renal impairment and those requiring blood transfusion. Long‐term survival was shortened for those patients with occlusive aortic disease and ischaemic heart disease. These risk factors should be carefully assessed in each patient before performing elective ARS.