Preoperative arterial blood lactate levels as a predictor of hospital mortality in patients with a ruptured abdominal aortic aneurysm.

PURPOSE

To establish if preoperative arterial blood lactate (Lac) is a factor related to hospital death for patients with a ruptured abdominal aortic aneurysm (rAAA).

METHODS

The subjects were 55 patients who underwent surgery for an rAAA in a single institution between July, 2000 and November, 2009. Patients were divided into a survivor group and a non-survivor group. We compared the preoperative Lac levels and other data between the groups.

RESULTS

There were ten hospital deaths. On univariate analysis, preoperative Lac levels, shock vital, cardiopulmonary resuscitation, Hardman index ≥3, and Glasgow aneurysm score ≥84 were significantly higher and preoperative hemoglobin was significantly lower in the non-survivor group. The postoperative mortality rate tended to increase with preoperative Lac levels. The mortality rate of patients with a preoperative Lac level higher than 9 mmol/l was 86 %. Those factors that had significant association with hospital mortality on univariate analysis were consecutively analyzed using multivariate logistic regression analysis. The multivariate logistic regression analysis revealed that a preoperative Lac level >9 mmol/l was the only independent risk factor of hospital mortality.

CONCLUSION

The preoperative Lac level of patients with a rAAA may be a predictor of their prognosis.