![]() ![]() One hundred twenty-two patients were admitted to the Long Island Jewish Medical Center with the diagnosis of RAAA in the period between January 1976 and July 1996, as identified by ICD-9 code. Patients who have a ruptured abdominal aortic aneurysm should not be denied therapy on the basis of any specific set of preoperative factors.(J Vasc Surg 1997 26:939-57.) Further studies should be directed to optimizing preoperative resuscitation. Conclusions: These findings suggest that the factors (loss of consciousness, creatinine level, hemoglobin level) that are predictive of death may be a reflection of shock in this patient population. In patients who had the sets of preoperative factors that were associated with a 100% mortality rate, there were intraoperative factors that influenced their death. The effects of the hemoglobin level, creatinine level, and loss of consciousness on the mortality rate were strongest in patients who had a lowest preoperative systolic blood pressure greater than 90 mm Hg. On a multivariate analysis, preoperative factors of loss of consciousness, a lowest preoperative systolic blood pressure less than 90 mm Hg, a hemoglobin level less than 10 g/dl, and a creatinine level greater than 1.5 mg/dl were predictive of death. No preoperative comorbid medical conditions were significant, nor was age. A history of loss of consciousness was also statistically significant. By univariate analysis of various factors associated with the mortality rate, hemoglobin level, creatinine level, lowest preoperative and average intraoperative systolic blood pressure, packed red blood cells transfused, estimated blood loss, intraoperative urine output, and temperature were statistically significant. The in-hospital mortality rate was 60.4%, with a 30-day mortality rate of 56.3%. The intraoperative mortality rate was 23%. Results: The mean age of the patients was 73 years. Data was analyzed by both univariate and multivariate analysis. Methods: A retrospective chart review of all patients who underwent repair of a ruptured abdominal aortic aneurysm was performed over a study period of 20 years. A retrospective review of 96 patients who underwent repair of a ruptured abdominal aortic aneurysm was performed to determine whether these factors would necessarily be applicable to all populations. Some studies have suggested restricting patient selection for repair on the basis of certain preoperative factors including age, increased creatinine level, low hemoglobin level, loss of consciousness, electrocardiographic changes, and preoperative cormorbid medical conditions. Purpose: There has been much discussion in the literature of factors that affect the mortality rate of patients who undergo repair of ruptured abdominal aortic aneurysms. Journal of Vascular Surgery Cases, Innovations and Techniques.Journal of Vascular Surgery: Venous and Lymphatic.
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