Predictors for outcome after open and endovascular repair of ruptured abdominal aortic aneurysms.

OBJECTIVES

The aims of the present study were to analyze patient- and management-related predictors for outcome after open (OR) and endovascular repair (EVAR) of ruptured abdominal aortic aneurysm (rAAA).

DESIGN

Retrospective study.

MATERIALS

The in-hospital registry of Malmö University Hospital identified 162 patients operated on due to rAAA between 2000 and 2004.

METHODS

Patient- and management-related predictors for outcome were analysed.

RESULTS

Preoperative CT in 39 out of 62 circulatory unstable patients was not associated with increased mortality (p=0.60). There was a significant increase in repairs performed by EVAR during the study period (p<0.001), and in 2004 EVAR exceeded the annual rate of OR. Patients in the EVAR group were older (p=0.025), whereas patients in the OR group more often suffered from unconsciousness after presentation (p=0.004). Age, unconsciousness after presentation and haemoglobin were significantly associated with in-hospital mortality when tested in a multivariate logistic regression model (p=0.002, p=0.003 and p<0.001, respectively). The in-hospital mortality for patients undergoing OR and EVAR was 45% (48/106) and 34% (19/56), respectively (p=0.16). Diagnosis of abdominal compartment syndrome (p=0.005) and intestinal infarction (p=0.002) was associated with poor survival.

CONCLUSIONS

Patient-related factors such as age, loss of consciousness and haemoglobin predicts outcome in a population where both emergency OR and EVAR for the treatment of rAAA is feasible.