RESUMO
BACKGROUND: The aim of the present study was to explore whether preoperative white blood cell (WBC) count may predict 30-day mortality and long-term survival following surgery for abdominal aortic aneurysm (AAA). Secondarily, we wanted to assess the potential sex differences in WBC in these patients. METHODS: The study was carried out as a retrospective cohort study. Patients undergoing surgery for intact and ruptured AAA (rAAA) at our institution consecutively in the time period 1994-2007 were included. Patients were either treated with open aneurysm repair or with endovascular aneurysm repair. Data were collected from the patients' medical records, including laboratory reports for WBC count prior to surgery. Mortality and long-term survival were extracted from The Patient Administrative System. RESULTS: A total of 988 patients were included, 712 (72%) patients were treated for intact AAA and 276 (28%) underwent surgery for rAAA. Patients with WBC ≥11 ×109/L had a 8.7-fold higher risk of 30-day mortality undergoing surgery for intact AAA compared to patients with WBC <11 ×109/L (95% confidence interval [CI]: 3.2-23.3, P < 0.001). Patients with a high WBC tended to have inferior long-term survival. However, when excluding 30-day mortality, no statistically significant difference was found (hazard ratio, 1.4; 95% CI: 0.9-2.0, P = 0.121). No association between WBC count and 30-day mortality or long-term survival was observed among patients treated for rAAA. We could not identify any sex differences in WBC, neither in intact AAA nor in rAAA. We were not able identify any association between WBC and specific causes of death. CONCLUSIONS: This study suggests that patients with WBC count ≥11 ×109/L prior to surgery for intact AAA have a higher 30-day mortality compared to patients with WBC <11 ×109/L. We could not identify any substantial difference in long-term survival when excluding 30-day mortality. We did not observe any association between preoperative WBC count and case fatality or long-term survival in patients undergoing surgery for rAAA. No sex differences in WBC were found.
Assuntos
Aneurisma da Aorta Abdominal/sangue , Aneurisma da Aorta Abdominal/cirurgia , Ruptura Aórtica/sangue , Ruptura Aórtica/cirurgia , Implante de Prótese Vascular , Procedimentos Endovasculares , Contagem de Leucócitos , Idoso , Idoso de 80 Anos ou mais , Aneurisma da Aorta Abdominal/diagnóstico , Aneurisma da Aorta Abdominal/mortalidade , Ruptura Aórtica/diagnóstico , Ruptura Aórtica/mortalidade , Implante de Prótese Vascular/efeitos adversos , Implante de Prótese Vascular/mortalidade , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/mortalidade , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Fatores de Tempo , Resultado do TratamentoRESUMO
BACKGROUND: The aim was to investigate early and long-term results following AAA repair during a 20-year period. METHOD: One thousand and forty one patients with AAA were treated with open surgery (905) or EVAR (136) during the period 1983-2002. Comorbidity and factors influencing early and long-term results were investigated. Data were collected retrospectively from the patients' medical records. A complete follow-up was obtained. RESULTS: Women had a significantly higher 30-day mortality following repair of ruptured AAA than men. The degree of emergency, advancing age and renal failure were significantly associated with 30-day mortality. We observed an improvement in long-term survival during the study period. Time interval of surgery, cerebrovascular disease, diabetes, COPD and renal failure influenced long-term survival negatively. CONCLUSION: Women with ruptured AAA have a higher early mortality than men, which needs to be investigated further. Long-term survival has improved during the study period. Age, diabetes, chronic obstructive pulmonary disease, renal failure and cerebrovascular insufficiency influenced the long-term survival negatively. EVAR is used to an increasing extent and the results are improving.
Assuntos
Aneurisma da Aorta Abdominal/mortalidade , Aneurisma da Aorta Abdominal/cirurgia , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Idoso , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Análise de Sobrevida , Fatores de Tempo , Resultado do TratamentoRESUMO
BACKGROUND: The goal of the present study was to investigate the number of operations for abdominal aortic aneurysm (AAA) including time-trends in treatment during a 20-year period. Operating time and anesthesia time were also studied. METHOD: During the period 1983-2002, a total of 1,041 patients with AAA were treated with open surgery (905) or EVAR (136). Number of operations, type of graft, anesthesia time, and operating time were the variables investigated. Data were collected retrospectively from the patients' medical records. RESULTS: There was an increase in the number of operations both for ruptured and non-ruptured AAA in men during the study period. Among women, an increase was observed only for ruptured aneurysm. Operating time and anesthesia time increased significantly during the 20-year period. The number of patients treated by EVAR increased significantly, beginning in 1995. CONCLUSIONS: In conclusion, there has been an increase in the number of AAA operations, and the proportion of patients treated with EVAR is increasing. Furthermore, we found an increase in both anesthesia time and operating time. These trends may be important for allocation of resources needed for the treatment of patients with AAA.
