Higher serum creatinine (P=0.002) and lower FEV1 (P=0.003) were strongly associated with 30-day postoperative mortality (overall rate 5.6%) following elective abdominal aortic aneurysm repair.
Cohort (n=820)
Yes
Poor preoperative lung and renal function are strong predictors of 30-day mortality following elective open surgical repair of abdominal aortic aneurysms.
BACKGROUND: In regional and population studies, the mortality rate within 30 days of elective surgical repair of abdominal aortic aneurysm is approximately 8 per cent. Identification of preoperative factors associated with this mortality risk is important for informing surgical policy and may suggest suitable preoperative interventions. METHODS: In the UK Small Aneurysm Trial, 820 patients aged 60-80 years underwent elective open surgical repair of an abdominal aortic aneurysm. The relationship between 30-day mortality rate and 13 prespecified potential prognostic factors was investigated. The value of a published clinical prediction rule was also evaluated. RESULTS: The postoperative mortality rate was 5.6 per cent overall (46 deaths in 820 patients). Postoperative mortality risk was significantly associated with older age (P = 0. 03), higher serum creatinine level (P = 0.002) and lower forced expiratory volume in 1 s (FEV1) (P = 0.003) in univariate analyses. Evidence of a relationship between age and postoperative death was weakened (P = 0.08) after adjustment for creatinine level and FEV1. The predicted postoperative mortality risk ranged from 2.7 per cent in younger patients with below average creatinine levels and above average FEV1, to 7.8 per cent in older patients with above average creatinine levels and below average FEV1. The published clinical prediction rule did not validate well on these data; observed risk did not correlate with predicted risk except for a small group of high-risk patients. CONCLUSION: Poor preoperative lung and renal function was strongly associated with postoperative death. Age was less important once these two important prognostic factors had been taken into account. The potential for preoperative improvement in lung and renal function to reduce postoperative mortality rates should be addressed in future studies.
Brady et al. (2000) conducted a cohort in Abdominal aortic aneurysm (n=820). Elective open surgical repair was evaluated on 30-day postoperative mortality rate. Higher serum creatinine (P=0.002) and lower FEV1 (P=0.003) were strongly associated with 30-day postoperative mortality (overall rate 5.6%) following elective abdominal aortic aneurysm repair.