DETERMINANTS OF THE POSTOPERATIVE AND LONG-TERM SURVIVAL OF PATIENTS WITH RUPTURED ABDOMINAL AORTIC-ANEURYSMS

To compare the surgical results of patients with ruptured (rAAA) and n onruptured abdominal aortic aneurysms (NrAAA), 267 consecutive patient s surgically treated for abdominal aortic aneurysms (AAA) were reviewe d, The patients' characteristics, preexistent risk factors, perioperat ive factors, and postoperative early and long-term survival were compa red between the rAAA group (n = 27) and the NrAAA group (n = 240), A m ultivariate analysis to predict postoperative survival was also conduc ted in the rAAA group, The hospital mortality rate was 3.3% (8/232) fo r the NrAAA group and 22.2% (6/27) for the rAAA group (P < 0.001), The maximum size of aneurysms, period of preoperative hypotension, and in traoperative bleeding volume were significantly higher in the rAAA gro up than in the NrAAA group, The 5- and 10-year cumulative survival rat es in the rAAA group were 88.1% and 42.0%, which were comparable to th ose in the NrAAA group, The incremental risk factors for hospital deat h in the rAAA group included advanced age, preoperative hypotension (< 80 mmHg), and postoperative renal failure requiring dialysis. These fi ndings showed that the interval from rupture to cross-clamping must be shortened, maintaining hemodynamic stability to avoid prolonged hypot ension, Reducing risk factors and minimizing deterioration of organ fu nctions postoperatively would be essential to improve the prognosis of patients with rAAA.