Predictors of Postoperative Mortality of Ruptured Abdominal Aortic Aneurysm: A Retrospective Clinical Study

Kim, Sang Dong; Hwang, Jeong Kye; Park, Sun Cheol; Kim, Ji Il; Moon, In Sung; Park, Jang Sang; Yun, Sang Seob

doi:10.3349/ymj.2012.53.4.772

Cited by 13 publications

(7 citation statements)

References 24 publications

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“…Measuring and reporting surgical mortality outcomes at 2-day, 16,17 7-day, [18][19][20] 30-day, 21 in-hospital, 22 in-hospital or 30-day, 23 and 60-and 90-day 24 intervals have been used to reflect the quality of care provided. The World Health Organization Safe Surgery Saves Lives initiative has adopted perioperative mortality as a quality-of-care estimate, 25 and a recently published Commission on Global Surgery report 26 in The Lancet settled on inpatient mortality statistics for tracking sur-gical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Thirty-Day Postoperative Mortality Risk Estimates and 1-Year Survival in Veterans Health Administration Surgery Patients

Smith

Nylander

et al. 2016

JAMA Surg

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Deciles of 30-day mortality estimates are associated with significantly different survival outcomes at 365 days even after removing patients who died within the first 30 postoperative days. No evidence of delays in patient care and treatment to meet a 30-day metric were identified. These findings reinforce the usefulness of 30-day mortality risk stratification as a surrogate for long-term outcomes.

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Section: Discussionmentioning

confidence: 99%

Thirty-Day Postoperative Mortality Risk Estimates and 1-Year Survival in Veterans Health Administration Surgery Patients

Smith

Nylander

et al. 2016

JAMA Surg

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“…These findings are in line with those reported in the current literature. Indeed, several studies underlined that total blood loss and intraoperative hypotension are significant predictors of death [ 25 , 26 , 27 , 28 ]. In our analysis, we considered hemoperitoneum as an indirect and non-numeric measure of blood loss, but it is intraoperatively objectifiable.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Predictors and Proposal for a Novel Prognostic Risk Score for In-Hospital Mortality after Open Repair of Ruptured Abdominal Aortic Aneurysms (SPARTAN Score)

Berchiolli,

Troisi,

Bertagna

et al. 2024

JCM

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(1) Background: Several mortality risk scores have been developed to predict mortality in ruptured abdominal aortic aneurysms (rAAAs), but none focused on intraoperative factors. The aim of this study is to identify intraoperative variables affecting in-hospital mortality after open repair and develop a novel prognostic risk score. (2) Methods: The analysis of a retrospectively maintained dataset identified patients who underwent open repair for rAAA from January 2007 to October 2023 in three Italian tertiary referral centers. Multinomial logistic regression was used to calculate the association between intraoperative variables and perioperative mortality. Independent intraoperative factors were used to create a prognostic score. (3) Results: In total, 316 patients with a mean age of 77.3 (SD ± 8.5) were included. In-hospital mortality rate was 30.7%. Hemoperitoneum (p < 0.001), suprarenal clamping (p = 0.001), and operation times of >240 min (p = 0.008) were negative predictors of perioperative mortality, while the patency of at least one hypogastric artery had a protective role (p = 0.008). Numerical values were assigned to each variable based on the respective odds ratio to create a risk stratification for in-hospital mortality. (4) Conclusions: rAAA represents a major cause of mortality. Intraoperative variables are essential to estimate patients’ risk in surgically treated patients. A prognostic risk score based on these factors alone may be useful to predict in-hospital mortality after open repair.

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“…The development of AKI is known to affect postoperative morbidity, mortality, and length of stay in patients undergoing AAA surgery [ 12 , 24 , 25 ]. Patients requiring RRT after AAA surgery have a high mortality rate [ 26 , 27 ]. Additionally, postoperative AKI not requiring RRT also increases the risk of postoperative mortality in patients undergoing open AAA repair [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Relationship between intraoperative dopamine infusion and postoperative acute kidney injury in patients undergoing open abdominal aorta aneurysm repair

Lee

Park

et al. 2022

BMC Anesthesiol

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Background Acute kidney injury (AKI) is one of the most common complications in patients undergoing open abdominal aortic aneurysm (AAA) repair. Dopamine has been frequently used in these patients to prevent AKI. We aimed to clarify the relationship between intraoperative dopamine infusion and postoperative AKI in patients undergoing open AAA repair. Methods We analyzed 294 patients who underwent open AAA repair at a single tertiary center from 2009 to 2018, retrospectively. The primary outcome was the incidence of postoperative AKI, determined by the Kidney Disease Improving Global Outcomes definition, after open AAA repair. Secondary outcomes included survival outcome, hospital and intensive care unit length of stay, and postoperative renal replacement therapy (RRT). Results Postoperative AKI occurred in 21.8% (64 out of 294 patients) The risk of postoperative AKI by intraoperative dopamine infusion was greater after adjusting for risk factors (odds ratio [OR] 2.56; 95% confidence interval [CI], 1.09–5.89; P = 0.028) and after propensity score matching (OR 3.22; 95% CI 1.12–9.24; P = 0.030). On the contrary, intraoperative norepinephrine use was not associated with postoperative AKI (use vs. no use; 19.3 vs. 22.4%; P = 0.615). Patients who used dopamine showed higher requirement for postoperative RRT (6.8 vs. 1.2%; P = 0.045) and longer hospital length of stay (18 vs. 16 days, P = 0.024). Conclusions Intraoperative dopamine infusion was associated with more frequent postoperative AKI, postoperative RRT, and longer hospital length of stay in patients undergoing AAA repair, when compared to norepinephrine. Further prospective randomized clinical trial may be necessary for this topic.

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Predictors of Postoperative Mortality of Ruptured Abdominal Aortic Aneurysm: A Retrospective Clinical Study

Cited by 13 publications

References 24 publications

Thirty-Day Postoperative Mortality Risk Estimates and 1-Year Survival in Veterans Health Administration Surgery Patients

Thirty-Day Postoperative Mortality Risk Estimates and 1-Year Survival in Veterans Health Administration Surgery Patients

Intraoperative Predictors and Proposal for a Novel Prognostic Risk Score for In-Hospital Mortality after Open Repair of Ruptured Abdominal Aortic Aneurysms (SPARTAN Score)

Relationship between intraoperative dopamine infusion and postoperative acute kidney injury in patients undergoing open abdominal aorta aneurysm repair

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