Perioperative mortality in abdominal aortic surgery.

Objective: To analyse pre and peroperative variables for predicting mortali ty after abdominal aortic surgery. Study design: Prospective study. Patients: We prospectively included 658 consecutive patients undergoing abd ominal aortic surgery from January 1993 to July 1997. Methods: Age, gender, hypertension, history of myocardial infarction or cor onary revascularization, angina pectoris, diabetes, arrhythmia, cardiac ins ufficiency, serum creatinine > 150 mu mol.L-1, beta-blockers therapy, calci um channel inhibitors, angiotensin converting enzyme inhibitors were preope rative analysed variable. Type of aortic disease (anevrysms versus aortic o cclusion), duration of surgery, blood loss, type of laparotomy (medium vers us lombotomy) were peroperative analysed variables. Haemoglobinemia was mon itored during surgery and patients were transfused if haemoglobinaemia < 80 g.L-1. Results: Thirty-three patients died after aortic surgery (5%). In multivari ate analysis, angina pectoris (OR = 5.47, P < 0.001), chronic obstructive b ronchopulmonary disease (OR = 2.27, P = 0.05) and duration of surgery (OR = 1.60, P < 0.001) were the independent predictive factors of mortality. Age , blood loss were predictive factors only in univariate analysis. Conclusion: Angina pectoris and COBP were the two independent preoperative factors of mortality. The duration of surgery was the only peroperative fac tor, Well monitored blood loss was not a predictive factor. (C) 2000 Editio ns scientifiques et medicales Elsevier SAS.