[Evaluation of factors influencing the result of surgical treatment in patients with ruptured aneurysm of the abdominal aorta and iliac arteries].

The aim of this paper was to analyze the risk factors influencing early and late results of postoperative therapy in patients with ruptured abdominal aortic aneurysm. The analysis included: age of patients, type and duration of symptoms, presence of shock prior to surgery, size of aneurysm, place of rupture, type of surgery and prosthesis, amount of blood transfused during the surgery, duration of the operation and occlusion. In conclusion the early results were evaluated on the basis of postoperative mortality. The examinations involved a group of 56 patients (49 males, 7 females) who had urgent surgeries in the years 1988-1995. Evaluation of the early results were based on case histories, results of some tests, anaesthetic charts and ICU files. The mean age was 66.7. During the surgery 7 patients died due to severe hemorrhagic shock. In the postoperative period 20 patients died due to complications. As a result the dependence between survival and 1) the presence of severe posthemorrhagic shock (Tab. 1), 2) the diseases the patients have suffered from particularly those of circulatory system (Tab. 4), 3) the type of surgery and prosthesis (Tab. 2, 3), 4) complications of postoperative period have been confirmed (Tab. 5). Other factors did not have any significant influence on the surgery. Examinations of the late results in 29 patients (the observation lasted 6-20 months) have been carried out. From this group--22 patients reported for follow-up examinations, 5--died, 1--lives abroad. The follow-up examinations revealed coexistence of hypertension in more than 60% of the patients and obliterative changes of peripheral arteries in about 30%. USG examination of the implanted prosthesis showed a proper blood flow in all patients, the presence of aneurysm of pseudoanastomosis has not been found.