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Article: Improvement of mortality of ruptured abdominal aortic aneurysm patients over 12 years and its relationship with tracheostomy

TitleImprovement of mortality of ruptured abdominal aortic aneurysm patients over 12 years and its relationship with tracheostomy
Authors
Issue Date2006
PublisherElsevier Inc.
Citation
Annals Of Vascular Surgery, 2006, v. 20 n. 2, p. 175-182 How to Cite?
AbstractCardiopulmonary complication after ruptured abdominal aortic aneurysm (rAAA) repair is an important cause of mortality. Early tracheostomy promotes patient recovery from respiratory morbidities. A policy of routine immediate tracheostomy was adopted in 1999 at our institution. This study investigates the trend of hospital mortality of rAAA patients over 12 years with particular reference to immediate tracheostomy. Consecutive rAAA patients operated during 1993-2004 were divided into two groups (first group, 1993-1998; second group, 1999-2002). lntra- and postoperative care was the same for all patients except that immediate tracheostomy was performed routinely in the second group and only selectively in the first. Hospital mortality of the two groups was examined. Patient characteristics, biochemical parameters, aneurysm feature, operative details, and clinical outcomes of the two groups (excluding 48 hr perioperative mortalities) were compared to identify prognostic factors of hospital mortality. Sixty-three patients were operated during the study period. The overall hospital mortality for the first and second groups was 62.5% (20/32) and 22.6% (7/31) (p = 0.001), respectively. Excluding the 48 hr mortalities, 57.1% (12, n = 21) of patients in the first group and 85.7% (24, n = 28) of those in the second group survived to be discharged from hospital (p = 0.048). The pre-, intra-, and postoperative parameters were comparable between the two groups. Immediate tracheostomy was performed for all patients in the second group and only 52.4% (11) in the first group. Male gender, high creatinine level on presentation, postoperation cardiac morbidity, renal failure, and bowel ischemia were found to be associated with a higher mortality. Immediate tracheostomy is a significant factor associated with improved survival. In conclusion, a significant improvement of rAAA patients' in-hospital mortality was achieved during the study period. Tracheostomy performed immediately following rAAA repair is associated with better hospital survival. © Annals of Vascular Surgery Inc.
Persistent Identifierhttp://hdl.handle.net/10722/83782
ISSN
2015 Impact Factor: 1.045
2015 SCImago Journal Rankings: 0.586
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorHo, Pen_HK
dc.contributor.authorCheng, SWKen_HK
dc.contributor.authorTing, ACWen_HK
dc.contributor.authorPoon, JTCen_HK
dc.date.accessioned2010-09-06T08:45:09Z-
dc.date.available2010-09-06T08:45:09Z-
dc.date.issued2006en_HK
dc.identifier.citationAnnals Of Vascular Surgery, 2006, v. 20 n. 2, p. 175-182en_HK
dc.identifier.issn0890-5096en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83782-
dc.description.abstractCardiopulmonary complication after ruptured abdominal aortic aneurysm (rAAA) repair is an important cause of mortality. Early tracheostomy promotes patient recovery from respiratory morbidities. A policy of routine immediate tracheostomy was adopted in 1999 at our institution. This study investigates the trend of hospital mortality of rAAA patients over 12 years with particular reference to immediate tracheostomy. Consecutive rAAA patients operated during 1993-2004 were divided into two groups (first group, 1993-1998; second group, 1999-2002). lntra- and postoperative care was the same for all patients except that immediate tracheostomy was performed routinely in the second group and only selectively in the first. Hospital mortality of the two groups was examined. Patient characteristics, biochemical parameters, aneurysm feature, operative details, and clinical outcomes of the two groups (excluding 48 hr perioperative mortalities) were compared to identify prognostic factors of hospital mortality. Sixty-three patients were operated during the study period. The overall hospital mortality for the first and second groups was 62.5% (20/32) and 22.6% (7/31) (p = 0.001), respectively. Excluding the 48 hr mortalities, 57.1% (12, n = 21) of patients in the first group and 85.7% (24, n = 28) of those in the second group survived to be discharged from hospital (p = 0.048). The pre-, intra-, and postoperative parameters were comparable between the two groups. Immediate tracheostomy was performed for all patients in the second group and only 52.4% (11) in the first group. Male gender, high creatinine level on presentation, postoperation cardiac morbidity, renal failure, and bowel ischemia were found to be associated with a higher mortality. Immediate tracheostomy is a significant factor associated with improved survival. In conclusion, a significant improvement of rAAA patients' in-hospital mortality was achieved during the study period. Tracheostomy performed immediately following rAAA repair is associated with better hospital survival. © Annals of Vascular Surgery Inc.en_HK
dc.languageengen_HK
dc.publisherElsevier Inc.en_HK
dc.relation.ispartofAnnals of Vascular Surgeryen_HK
dc.rightsAnnals of Vascular Surgery. Copyright © Elsevier Inc.en_HK
dc.subject.meshAortic Aneurysm, Abdominal - mortality - surgeryen_HK
dc.subject.meshAortic Rupture - mortality - surgeryen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHeart Diseases - complicationsen_HK
dc.subject.meshHospital Mortality - trendsen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshPostoperative Complications - etiology - mortality - surgeryen_HK
dc.subject.meshRenal Insufficiency - complicationsen_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshRisk Factorsen_HK
dc.subject.meshSex Factorsen_HK
dc.subject.meshTracheostomyen_HK
dc.subject.meshVascular Surgical Proceduresen_HK
dc.titleImprovement of mortality of ruptured abdominal aortic aneurysm patients over 12 years and its relationship with tracheostomyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0890-5096&volume=20&issue=2&spage=175&epage=182&date=2006&atitle=Improvement+of+mortality+of+ruptured+abdominal+aortic+aneurysm+patients+over+12+years+and+its+relationship+with+tracheostomyen_HK
dc.identifier.emailCheng, SWK: wkcheng@hkucc.hku.hken_HK
dc.identifier.emailPoon, JTC: tcjensen@hkucc.hku.hken_HK
dc.identifier.authorityCheng, SWK=rp00374en_HK
dc.identifier.authorityPoon, JTC=rp01603en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s10016-006-9002-6en_HK
dc.identifier.pmid16557427-
dc.identifier.scopuseid_2-s2.0-33646496803en_HK
dc.identifier.hkuros115603en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33646496803&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume20en_HK
dc.identifier.issue2en_HK
dc.identifier.spage175en_HK
dc.identifier.epage182en_HK
dc.identifier.isiWOS:000237323200002-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridHo, P=24469553100en_HK
dc.identifier.scopusauthoridCheng, SWK=7404684779en_HK
dc.identifier.scopusauthoridTing, ACW=7102858552en_HK
dc.identifier.scopusauthoridPoon, JTC=7005903722en_HK

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