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Open surgery in endovascular aneurysm repair era: simplified classification in two risk groups owing to factors affecting mortality in 137 ruptured abdominal aortic aneurysms (RAAAs)
Our objective is to identify in 137 true RAAAs operated consecutively in open surgery: (1) diagnostic therapeutic aspects capable of influencing results, (2) risk classes with different prognosis, (3) any situations where the prognosis is so negative that surgery is not recommended. The relationship...
Autores principales: | , , , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
Publicado: |
Springer Milan
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047051/ https://www.ncbi.nlm.nih.gov/pubmed/21336876 http://dx.doi.org/10.1007/s13304-011-0053-z |
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author | Bonardelli, Stefano Cervi, Edoardo Maffeis, Roberto Nodari, Franco De Lucia, Maurizio Guadrini, Cristina Viotti, Fabio Portolani, Nazario Giulini, Stefano Maria |
author_facet | Bonardelli, Stefano Cervi, Edoardo Maffeis, Roberto Nodari, Franco De Lucia, Maurizio Guadrini, Cristina Viotti, Fabio Portolani, Nazario Giulini, Stefano Maria |
author_sort | Bonardelli, Stefano |
collection | PubMed |
description | Our objective is to identify in 137 true RAAAs operated consecutively in open surgery: (1) diagnostic therapeutic aspects capable of influencing results, (2) risk classes with different prognosis, (3) any situations where the prognosis is so negative that surgery is not recommended. The relationship of 16 anamnestic, clinical and technical parameters prospectively collected with 30-day mortality was retrospectively evaluated by uni- and multivariate analyses. Thirty-day mortality was 37%. The univariate analysis identified as mortality predictors Hb ≤ 8 g/dl and circulatory shock at hospitalisation, but following the multivariate analysis only circulatory shock was a certainly significant risk-factor. The cumulative effect on mortality of the two parameters identified at univariate analysis translates into a statistically significant difference in mortality between two groups of patients: A (no or just one risk-factor) and B (two risk-factors). To reinstate euvolemia, rather than adequate haemoglobin values, improves the chances of success. A simple prognostic index into two risk classes is feasible, but abstention from surgery is not justified in any type of patient. |
format | Text |
id | pubmed-3047051 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | Springer Milan |
record_format | MEDLINE/PubMed |
spelling | pubmed-30470512011-04-05 Open surgery in endovascular aneurysm repair era: simplified classification in two risk groups owing to factors affecting mortality in 137 ruptured abdominal aortic aneurysms (RAAAs) Bonardelli, Stefano Cervi, Edoardo Maffeis, Roberto Nodari, Franco De Lucia, Maurizio Guadrini, Cristina Viotti, Fabio Portolani, Nazario Giulini, Stefano Maria Updates Surg Original Article Our objective is to identify in 137 true RAAAs operated consecutively in open surgery: (1) diagnostic therapeutic aspects capable of influencing results, (2) risk classes with different prognosis, (3) any situations where the prognosis is so negative that surgery is not recommended. The relationship of 16 anamnestic, clinical and technical parameters prospectively collected with 30-day mortality was retrospectively evaluated by uni- and multivariate analyses. Thirty-day mortality was 37%. The univariate analysis identified as mortality predictors Hb ≤ 8 g/dl and circulatory shock at hospitalisation, but following the multivariate analysis only circulatory shock was a certainly significant risk-factor. The cumulative effect on mortality of the two parameters identified at univariate analysis translates into a statistically significant difference in mortality between two groups of patients: A (no or just one risk-factor) and B (two risk-factors). To reinstate euvolemia, rather than adequate haemoglobin values, improves the chances of success. A simple prognostic index into two risk classes is feasible, but abstention from surgery is not justified in any type of patient. Springer Milan 2011-02-19 2011 /pmc/articles/PMC3047051/ /pubmed/21336876 http://dx.doi.org/10.1007/s13304-011-0053-z Text en © The Author(s) 2011 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. |
spellingShingle | Original Article Bonardelli, Stefano Cervi, Edoardo Maffeis, Roberto Nodari, Franco De Lucia, Maurizio Guadrini, Cristina Viotti, Fabio Portolani, Nazario Giulini, Stefano Maria Open surgery in endovascular aneurysm repair era: simplified classification in two risk groups owing to factors affecting mortality in 137 ruptured abdominal aortic aneurysms (RAAAs) |
title | Open surgery in endovascular aneurysm repair era: simplified classification in two risk groups owing to factors affecting mortality in 137 ruptured abdominal aortic aneurysms (RAAAs) |
title_full | Open surgery in endovascular aneurysm repair era: simplified classification in two risk groups owing to factors affecting mortality in 137 ruptured abdominal aortic aneurysms (RAAAs) |
title_fullStr | Open surgery in endovascular aneurysm repair era: simplified classification in two risk groups owing to factors affecting mortality in 137 ruptured abdominal aortic aneurysms (RAAAs) |
title_full_unstemmed | Open surgery in endovascular aneurysm repair era: simplified classification in two risk groups owing to factors affecting mortality in 137 ruptured abdominal aortic aneurysms (RAAAs) |
title_short | Open surgery in endovascular aneurysm repair era: simplified classification in two risk groups owing to factors affecting mortality in 137 ruptured abdominal aortic aneurysms (RAAAs) |
title_sort | open surgery in endovascular aneurysm repair era: simplified classification in two risk groups owing to factors affecting mortality in 137 ruptured abdominal aortic aneurysms (raaas) |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047051/ https://www.ncbi.nlm.nih.gov/pubmed/21336876 http://dx.doi.org/10.1007/s13304-011-0053-z |
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