Risk factors for predicting postoperative complications after open infrarenal abdominal aortic aneurysm repair: results from a single vascular center in China

• Published in: Journal of clinical anesthesia Vol. 25; no. 5; pp. 371 - 378
• Main Authors: Li, Cai, MD, Yang, Wen-Han, MD, Zhou, Jun, MD, PhD, Wu, Yan, MD, Li, Yun-Sheng, MD, Wen, Shi-Hong, MD, Huang, Wen-Qi, MD, Liu, Ke-Xuan, MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.08.2013; Elsevier; Elsevier Limited
• Subjects: Abdominal; Adult; Age Factors; Aged; Aged, 80 and over; Anesthesia; Anesthesia & Perioperative Care; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Aneurysms; Aortic aneurysm; Aortic Aneurysm, Abdominal - surgery; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular disease; China - epidemiology; Chronic obstructive pulmonary disease; Diseases of the aorta; Emergencies; Female; Hospitals, University; Humans; Incidence; Logistic Models; Male; Medical sciences; Middle Aged; Models, Statistical; Mortality; Pain Medicine; Postoperative complications; Postoperative Complications - epidemiology; Pulmonary Disease, Chronic Obstructive - complications; Respiratory distress syndrome; Retrospective Studies; Risk Factors; Time Factors; Treatment Outcome; Vascular Surgical Procedures - adverse effects; Vascular Surgical Procedures - methods; Asia; China; Abdominal; Aortic aneurysm; Mortality; Postoperative complications; Postoperative; Prediction; Cardiovascular disease; Abdomen; Result; Abdominal aorta; Blood vessel; Risk factor; Complication; Repair
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2013.01.013

Abstract Study Objective To identify the risk factors of, and develop a prediction model for, postoperative complications of patients undergoing infrarenal abdominal aortic aneurysm (IAAA) repair. Design Retrospective analysis. Setting Vascular surgery center of a university hospital. Measurements The clinical data of 316 IAAA cases were collected from January 2004 to October 2010 at a single vascular center in China. Postoperative complications were observed within 30 days after surgery. Patient-specific and operation-specific characteristics were analyzed in relation to postoperative complications using multiple logistic regression analysis. Main Results Overall incidence of postoperative complications and overall 30-day mortality of IAAA repair patients were 48.4% (153/316) and 8.8% (28/316), respectively. Postoperative complications involved pulmonary (18.9%), cardiac (14.2%), renal (7.3%), gastrointestinal (5.4%), neurologic (1.3%), and hepatic (0.9%) systems, and acute arterial embolism of the lower limb occurred in 1.3% of cases. Risk factors were age [> 65 yrs; odds ratio (OR) 1.6], aortic occlusion time (> 90 min; OR 2.4), history of chronic obstructive pulmonary disease (COPD; OR 4.4), emergency operation (OR 6.1), and history of cardiac dysfunction (OR 2.1). Conclusions A combination of age, COPD, emergency operation, history of cardiac dysfunction and aortic occlusion time has significant impact on postoperative complications after open IAAA repair.