Polski
Perioperative factors influencing the mortalit
open access
Abstract
INTRODUCTION: Abdominal aorta aneurysm is a recognized cause of death for the European population. The identification of intra-operative risk factors for perioperative death is of crucial importance for the society.
MATERIAL AND METHODS: A prospective observational study was conducted in the Vascular Surgery Department of the Pomeranian Medical University in Szczecin, Poland. The study group consisted of 95 patients, diagnosed with abdominal aorta aneurysm in the sub-renal region scheduled for an operative procedure of straight vascular graft implantation. Patient qualification was fulfilled according to TASC criteria. The influence of preoperative factors, hemodynamic and metabolic parameters on the risk of death in the study population was analyzed. Postoperatively, observation was continued for 28 days.
RESULTS: In this study group an increase of lactate, potassium levels or pH decrease during the first minute post cross-clamp release were significant risk factors for perioperative death. The importance of metabolic parameters is a recognized risk factor, however their statistical significance within the first minute post cross-clamp release is in our opinion of crucial importance. Additionally, significantly higher mortality was reported among patients without epidural anaesthesia. No importance of other analyzed parameters was found.
CONCLUSIONS: Epidural anaesthesia is an independent factor decreasing mortality in the early postoperative period in patients undergoing abdominal aorta aneurysm repair. A decrease of pH value and increase of lactate and K+ levels within the first minute after aortic cross-clamp release may be a valuable tool in identifying patients with an increased risk of perioperative death after abdominal aorta prosthesis implantation.
Abstract
INTRODUCTION: Abdominal aorta aneurysm is a recognized cause of death for the European population. The identification of intra-operative risk factors for perioperative death is of crucial importance for the society.
MATERIAL AND METHODS: A prospective observational study was conducted in the Vascular Surgery Department of the Pomeranian Medical University in Szczecin, Poland. The study group consisted of 95 patients, diagnosed with abdominal aorta aneurysm in the sub-renal region scheduled for an operative procedure of straight vascular graft implantation. Patient qualification was fulfilled according to TASC criteria. The influence of preoperative factors, hemodynamic and metabolic parameters on the risk of death in the study population was analyzed. Postoperatively, observation was continued for 28 days.
RESULTS: In this study group an increase of lactate, potassium levels or pH decrease during the first minute post cross-clamp release were significant risk factors for perioperative death. The importance of metabolic parameters is a recognized risk factor, however their statistical significance within the first minute post cross-clamp release is in our opinion of crucial importance. Additionally, significantly higher mortality was reported among patients without epidural anaesthesia. No importance of other analyzed parameters was found.
CONCLUSIONS: Epidural anaesthesia is an independent factor decreasing mortality in the early postoperative period in patients undergoing abdominal aorta aneurysm repair. A decrease of pH value and increase of lactate and K+ levels within the first minute after aortic cross-clamp release may be a valuable tool in identifying patients with an increased risk of perioperative death after abdominal aorta prosthesis implantation.
Full Text:
View HTML
Keywords
infrarenal aortic aneurysm, perioperative mortality, metabolic parameters
About this articleTitle
Perioperative factors influencing the mortalit
Journal
Issue
Article type
Research paper
Pages
1-8
Published online
2013-04-10
Page views
1439
Article views/downloads
1196
Bibliographic record
Acta Angiologica 2013;19(1):1-8.
Keywords
infrarenal aortic aneurysm
perioperative mortality
metabolic parameters
Authors
Maciej Żukowski
Jowita Biernawska
Katarzyna Kotfis
Mariusz Kaczmarczyk
Romuald Bohatyrewicz
Miłosław Cnotliwy
Joanna Sołek-Pastuszka
Mirosław Brykczyński
Andrzej Ciechanowicz