Zwanzig jahre chirurgie des abdominellen aorten-aneurysmas: Eine multivariate analyse perioperativer risikofaktoren bei 528 patienten

The significance of factors influencing the perioperative mortality of elective and urgent aneurysm repair are discussed. Prognostic factors affecting survival were analyzed in 528 patients with ruptured and unruptured AAA who were operated on within a 20-year period. In patients with ruptured AAA, multivariate analysis revealed that preoperative shock index, ASA score, intraoperative administration of aprotinin, and clamping time of the aorta are predictive of extended survival. No independent factors could be found in patients with unruptured AAA. In our experience, early complications and mortality in patients with ruptured AAA may be reduced by avoiding circulatory shock preoperatively, shortening clamping time and in cases of clotting impairment refractory to substitution by high-dose administration of aprotinin intraoperatively. Nonetheless, preoperative risk factors of these patients affect the postoperative course that cannot be influenced by the surgeon.