Risk factors and surgical prognosis in patients with infra-renal abdominal aortic aneurysms

Background: This study was conducted to explore the risk factors of surgery and complication-free survival rate in our patients with infra-renal abdominal aortic aneurysms. Methods: From January 1994 to December 2006, a total of 81 infra-renal abdominal aortic aneurysm patients (14 ruptured aneurysms, 67 electives) were admitted to undergo operation. Patient who had thoraco-abdominal aneurysms, mycotic aneurysms, iatrogenic aneurysms, traumatic aneurysms, or patients who underwent other surgery at the same time were excluded from this study. The research was conducted based on review of medical records and interviews with patients. Results: Our cohort (N = 81) had mean age of 71.0 ± 7.6 years, female-to-male ratio of 13:68, follow-up duration of 5.2 ± 3.3 years, and person-time of 420.3 person-years. There was 1 surgical/hospital death (1.5%) among the 67 elective cases. There were 2 (14.3%) surgical deaths and 5 (35.7%) hospital deaths among the 14 ruptured cases. Survivals with free to major graft-related complications were 100% at 5 years and 87% at 10 years. Under multivariate analysis, surgical status (emergent vs. elective), the diameter of aneurysm, ICU stay, and numbers of complications determined the long-term survival of a patient. For emergent group, a patient's systolic blood pressure in the operation room predicted the surgical prognosis. Conclusion: Once the need to have surgical repair of abdominal aortic aneurysm is indicated, timely operation and avoidance of surgical complications keep in-hospital mortality rate low and optimize the long-term survival in Chinese patients.