Haveman Jan W, Zeebregts Clark J, Verhoeven Eric L G, van den Berg P, van den Dungen Jan J A M, Zwaveling Jan H, Nijsten Maarten W N
Department of Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands.
Surg Today. 2008;38(12):1091-101. doi: 10.1007/s00595-008-3798-3. Epub 2008 Nov 28.
Many laboratory values are abnormal after surgery for a ruptured abdominal aortic aneurysm (RAAA). However, these changes have not been comprehensively evaluated. We analyzed the changes in routine laboratory values and how these changes related to outcome in a consecutive series of RAAA patients.
All patients who underwent surgery for an RAAA between January 1990 and June 2003 at our hospital were included in this study. We analyzed laboratory data acquired during the first week for all patients and at discharge for survivors. We categorized 29 different measurements into six categories based on the related pathological process, including hematology and coagulation, metabolism, systemic inflammation, renal function, liver function, and electrolytes.
A total of 290 patients underwent RAAA surgery, with a hospital mortality of 34%. Hemorrhage was the most common cause of early death, whereas multiple-organ failure (MOF) was the most common cause of death several days after surgery. Most laboratory values deviated from normal at multiple time points and they differed significantly between survivors and nonsurvivors.
Both survivors and nonsurvivors of RAAA surgery displayed characteristic time-dependent laboratory abnormalities. Awareness of these responses may help us predict patients prone to complications.
腹主动脉瘤破裂（RAAA）手术后许多实验室检查值会异常。然而，这些变化尚未得到全面评估。我们分析了一系列连续的RAAA患者常规实验室检查值的变化以及这些变化与预后的关系。
本研究纳入了1990年1月至2003年6月在我院接受RAAA手术的所有患者。我们分析了所有患者第一周及幸存者出院时获得的实验室数据。我们根据相关病理过程将29项不同测量指标分为六类，包括血液学和凝血、代谢、全身炎症、肾功能、肝功能和电解质。
共有290例患者接受了RAAA手术，医院死亡率为34%。出血是早期死亡的最常见原因，而多器官功能衰竭（MOF）是术后数天死亡的最常见原因。大多数实验室检查值在多个时间点偏离正常，且幸存者和非幸存者之间存在显著差异。
RAAA手术的幸存者和非幸存者均表现出特征性的时间依赖性实验室异常。了解这些反应可能有助于我们预测易发生并发症的患者。
