Outcome of acute renal failure following surgical repair of ruptured abdominal aortic aneurysms

Objectives: to establish the mortality of ARF following surgical repair of ruptured abdominal aortic aneurysms (AAAs) and to identify clinical variabl es which might assist in predicting outcome. Design, materials and methods: all cases of ARF complicating repair of rupt ured AAAs treated at Leicester General Hospital between 1984 and 1996 were identified in a retrospective stud based on review of clinical records. The main outcome measured were overall mortality, duration of hospital treatme nt and renal function in survivors. Results: in 65 cases identified, overall hospital mortality was 75%. Six pa tients did not receive RRT, since their clinical state was judged irreversi ble all died. Of the 16 survivors, 11 were left with irreversible renal imp airment and one patient required maintenance dialysis. Over half of the sur vivors had died at 5 years' follow-up. Non-survivors had more vascular dise ase (p = 0.048), required more surgery during AAA repair (p = 0.042) and we re more likely to have developed multiple organ failure (p = 0.01). A clini cal severity score based on these three variables allowed stratification in to prognostic groups. Conclusions: ARF following surgical repair of ruptured AAA has an overall h ospital mortality of 75%. A clinical severity score, calculated at the time dialysis was considered, may assist in prediction of outcome.