open access

Vol 45, No 1 (2013 Jan-Mar)
Original and clinical articles
Published online: 2013-03-19
Submitted: 2013-03-19
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Perioperative prognostic factors in patients with ruptured abdominal aortic aneurysms treated in the intensive care unit

Danuta Gierek, Tomasz Cyzowski, Adrianna Kaczmarska, Anna Janowska-Rodak, Barbara Budziarz, Tomasz Koczur
DOI: 10.5603/AIT.2013.0005
·
Anaesthesiol Intensive Ther 2013;45(1):25-29.

open access

Vol 45, No 1 (2013 Jan-Mar)
Original and clinical articles
Published online: 2013-03-19
Submitted: 2013-03-19

Abstract

BACKGROUND: The incidence of abdominal aortic aneurysm has been estimated at 20–40 cases per 100,000 per annum. The disease is often asymptomatic; in many cases, its first symptom is shock caused by a ruptured aneurysm. The aim of the present study was to assess retrospectively the selected perioperative factors in patients hospitalised in the intensive care unit (ICU) after repair of ruptured abdominal aortic aneurysm.

METHODS: Analysis involved medical records of patients after repair of ruptured abdominal aortic aneurysm treated in ICU in the years 2009–2010. Patients were divided into two groups: group I — survivors who were discharged from ICU and group II — non-survivors. Demographic factors, intraoperative data, vital parameters, laboratory results and severity of patient’s state on admission to ICU were analysed.

RESULTS: Analysis of laboratory results on admission to ICU showed lower values of pH and HCO3 - concentrations as well as higher international normalised ratio (INR) and activated partial thromboplastin time (APTT) in group II. Mean intraoperative diuresis differed between the groups; in group I — 303 mL and in group II — 155 mL. Mean diuresis on ICU day 1 was higher in group I compared to group II, i.e. 20.87 and 11.27 mL kg b.w.-1, respectively. APACHE II, SAPS II, MODS and SOFA point values were higher in group I than in group II.

CONCLUSIONS: Markers of impaired homeostasis, such as pH, HCO3 -concentration, INR and APTT assessed on admission to ICU can be relevant prognostic factors in patients after repair of ruptured abdominal aortic aneurysm. Monitoring of diuresis during surgery and on day 1 of ICU treatment was a sensitive risk marker for acute kidney injury. Multiple organ failure scales such as APACHE II, MODS, SOFA and SAPS II were reliable prognostic tools to be used in the early period of ICU treatment.

Abstract

BACKGROUND: The incidence of abdominal aortic aneurysm has been estimated at 20–40 cases per 100,000 per annum. The disease is often asymptomatic; in many cases, its first symptom is shock caused by a ruptured aneurysm. The aim of the present study was to assess retrospectively the selected perioperative factors in patients hospitalised in the intensive care unit (ICU) after repair of ruptured abdominal aortic aneurysm.

METHODS: Analysis involved medical records of patients after repair of ruptured abdominal aortic aneurysm treated in ICU in the years 2009–2010. Patients were divided into two groups: group I — survivors who were discharged from ICU and group II — non-survivors. Demographic factors, intraoperative data, vital parameters, laboratory results and severity of patient’s state on admission to ICU were analysed.

RESULTS: Analysis of laboratory results on admission to ICU showed lower values of pH and HCO3 - concentrations as well as higher international normalised ratio (INR) and activated partial thromboplastin time (APTT) in group II. Mean intraoperative diuresis differed between the groups; in group I — 303 mL and in group II — 155 mL. Mean diuresis on ICU day 1 was higher in group I compared to group II, i.e. 20.87 and 11.27 mL kg b.w.-1, respectively. APACHE II, SAPS II, MODS and SOFA point values were higher in group I than in group II.

CONCLUSIONS: Markers of impaired homeostasis, such as pH, HCO3 -concentration, INR and APTT assessed on admission to ICU can be relevant prognostic factors in patients after repair of ruptured abdominal aortic aneurysm. Monitoring of diuresis during surgery and on day 1 of ICU treatment was a sensitive risk marker for acute kidney injury. Multiple organ failure scales such as APACHE II, MODS, SOFA and SAPS II were reliable prognostic tools to be used in the early period of ICU treatment.

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Keywords

abdominal aortic aneurysm, ruptured; intensive therapy, prognosis; intensive therapy, prognostic scales

About this article
Title

Perioperative prognostic factors in patients with ruptured abdominal aortic aneurysms treated in the intensive care unit

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 45, No 1 (2013 Jan-Mar)

Pages

25-29

Published online

2013-03-19

DOI

10.5603/AIT.2013.0005

Bibliographic record

Anaesthesiol Intensive Ther 2013;45(1):25-29.

Keywords

abdominal aortic aneurysm
ruptured
intensive therapy
prognosis
intensive therapy
prognostic scales

Authors

Danuta Gierek
Tomasz Cyzowski
Adrianna Kaczmarska
Anna Janowska-Rodak
Barbara Budziarz
Tomasz Koczur

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