Moro H, Sugawara M, Shinonaga M, Hayashi J, Eguchi S, Terashima M, Kasuya S, Yamazaki Y, Satoh Y, Maruyama Y
Second Department of Surgery, Niigata University School of Medicine, Niigata City, Japan.
Surg Today. 1998;28(12):1242-6. doi: 10.1007/BF02482807.
This study was undertaken to examine the long-term survival rates of patients following abdominal aortic aneurysm (AAA) repair in comparison with an age-matched normal population, and to determine by multivariate analysis the factors influencing long-term survival. Of 125 patients who underwent AAA repair prior to July 1986, 13 died during hospitalization. Of these 13 patients, 6 who suffered aneurysmal rupture all died within 30 days. The survival rate of patients with ruptured aortic aneurysms was significantly lower than that of those with nonruptured aneurysms. Of the 112 patients surviving hospitalization, 85 died within 0.48 to 24 years after their operation. The long-term survival rate of patients who had suffered a preoperative cardiovascular event was significantly lower than that of those who had not suffered a preoperative cardiovascular event. The actual survival rate was significantly lower than the expected survival rate. According to a multivariate analysis, the significant predictors of late survival were age, aneurysmal rupture, and chronic renal failure in all the patients, and age, chronic renal failure, and pre- and postoperative cardiovascular events in patients who did not die in hospital. These findings indicate the importance of improving immediate perioperative management of ruptured AAA and that cardiovascular events should be prevented, or treated during long-term follow-up.
本研究旨在对比腹主动脉瘤(AAA)修复术后患者与年龄匹配的正常人群的长期生存率,并通过多因素分析确定影响长期生存的因素。在1986年7月之前接受AAA修复术的125例患者中,13例在住院期间死亡。在这13例患者中,6例因动脉瘤破裂死亡,均在30天内。主动脉瘤破裂患者的生存率显著低于未破裂患者。在112例住院存活患者中,85例在术后0.48至24年内死亡。术前发生心血管事件的患者长期生存率显著低于未发生术前心血管事件的患者。实际生存率显著低于预期生存率。多因素分析显示,所有患者晚期生存的显著预测因素为年龄、动脉瘤破裂和慢性肾衰竭,未在医院死亡的患者中,晚期生存的显著预测因素为年龄、慢性肾衰竭以及术前和术后心血管事件。这些发现表明改善破裂AAA围手术期即刻管理的重要性,并且应在长期随访期间预防或治疗心血管事件。