Outcome in patients requiring renal replacement therapy after open surgical repair for ruptured abdominal aortic aneurysm.

Vasc Endovascular Surg

University of Birmingham, Department of Vascular Surgery, Heart of England NHS Foundation Trust, Birmingham, United Kingdom.

Published: April 2010

Objective: To determine the relationship between postoperative renal replacement therapy (RRT) and patient survival after open surgical repair (OR) of ruptured abdominal aortic aneurysm (rAAA).

Methods: A retrospective review of consecutive patients who underwent OR for rAAA repair between January 2002 and July 2008 was performed. Early (<30 days) and late (>30 days) outcomes were assessed.

Results: A total of 94 patients (69 men; median [range] age 73.8 [56-89] years) underwent OR of rAAA (infrarenal = 78, juxtarenal = 15, and suprarenal = 1). In-hospital mortality rate was 40% and mean (range) length of intensive care unit (ICU) stay was 9.3 (0-56) days. A total of 23 (24%) patients required postoperative RRT. In-hospital mortality rate was significantly higher (RRT: 87% (20 of 23) vs no RRT: 18 of 71 (25%), P < .0001) and ICU stay significantly longer (RRT: mean (range) days; 14.8 (1-44) vs no RRT: 7.5 (0-56), P = .04) in the RRT patients. On multivariate analysis, RRT (P = .0053) and/or inotropic support (P = .0033) were independent risk factors for death within 30 days of the index procedure.

Conclusions: Renal replacement therapy following OR of rAAA is an independent risk factor for mortality.

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Source
http://dx.doi.org/10.1177/1538574410361972DOI Listing

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