Infrarenal aortofemoral bypass surgery: risk factors and mortality in 330 patients with abdominal aortic aneurysm or aortoiliac occlusive disease.

330 patients operated on for infrarenal abdominal aortic aneurysm (AAA) or aortoiliac occlusive disease (AIOD) between 1976-85 were retrospectively reviewed for early mortality and long-term survival. Data were analysed by crosstabulation and stepwise logistic regression methods for early mortality and by Kaplan-Meyer and Cox proportional hazard model for late survival. The 30-day mortality for elective AAA-patients was 9.6% and for ruptures 64.6%. For the AIOD-patients it was 2.0%. The principal cause of early death in the elective patients was acute myocardial infarction. The five-year survival rates for elective and ruptured AAA and AIOD-patients were 68%, 56% and 74%, respectively. The major late cause of death was coronary heart disease followed by pulmonary cancer. The risk factors for 30-day mortality were coronary heart disease, rupture, preoperative shock, excessive bleeding and aortic crossclamping time for the AAA-patients. In the rupture group the specialization of the surgeon had a significant impact on early mortality. Factors affecting the late survival were age, chronic cardiac failure, operation year, chronic pulmonary disease and previous malignancy in the whole study population. The late survival of both AAA and AIOD-patients after a successful operation was significantly shorter than that of an age- and sexmatched normal population. The late survival of AAA-patients was worse than that of AIOD-patients.