Abstract
Forty-seven patients (34 males and 13 females) over 75 years of age (mean: 79.7±3.8 SD) suffering from a ruptured abdominal aortic aneurysm were operated on between 1977 and 1986. In 16 patients (34%), the aneurysm had been diagnosed previously. Seventeen patients (36%) had a delay of 6 hours or more in the beginning of the treatment and 26 (55%) were in shock preoperatively. The mean diameter of the aneurysms was 8.9±2.6 cm (SD) and the mean operative bleeding was 8.5±7.8 (SD) liters. The mean operating time was 220±96 (SD) minutes. The 1-month mortality was 60% (28 patients) and 63% (12 patients) of survivors had postoperative complications, mostly pneumonia. The 5-year survival rate was 26%. In the analysis of risk factors associated with death, preoperative shock, old age, and a previously diagnosed but untreated abdominal aortic aneurysm were associated with a significantly worse prognosis.
Résumé
Quarante-sept patients (34 hommes et 13 femmes) âgés de plus de 75 ans (moyenne 79.7±3.8 SD) présentant une rupture d'anévrysme de l'aorte abdominale ont été opérés entre 1977 et 1986. Chez 16 patients (34%), l'anévrysme était déjà connu. Dix-sept patients (36%) ont été opérés 6 heures ou plus après le début de la rupture; 26 (55%) étaient en état de choc avant l'opération. Le diamètre moyen des anévrysmes était de 8.9±2.6 cm (SD) et la perte sanguine moyenne était de 8.5±7.8 litres. La durée moyenne de l'intervention était de 220±96 minutes. La mortalité à un mois était de 60% (28 patients) et 63% (12 patients) présentaient des complications postopératoires, le plus souvent des pneumopathies. La survie à 5 ans était de 26%. Les facteurs de risque associés à une mortalité élevée et à un mauvais prognostic étaient la présence de choc opératoire, le grand âge et la présence d'un anévrysme diagnostiqué mais non traité.
Resumen
Cuarenta y siete pacientes (34 hombres y 13 mujeres) mayores de 75 años (promedio: 79.7±3.8) con aneurismas rotos de la aorta abdominal fueron operados entre 1977 y 1986. En 16 pacientes (34%) el aneurisma había sido previamente diagnosticado. Diez y siete pacientes (36%) exhibieron demora de 6 horas o más en la iniciación del tratamiento y 26 (55%) estuvieron en shock en la fase preoperatoria. El diámetro promedio del aneurisma fue 8.9±2.6 centímetres y la cantidad promedio del sangrado operatorio fue 8.5±7.8 litres. El tiempo operatorio promedio fue 220±96 minutos. La mortalidad a un mes fue 60% (28 pacientes) y 63% (12 pacientes) de los sobrevivientes sufrieron complicaciones postoperatorias, principalmente neumonía. La tasa de sobrevida a 5 años fue 26%. En cuanto al análisis de los factores de riesgo asociados con mortalidad, el shock preoperatorio, la edad avanzada, y un aneurisma aórtico previamente diagnosticado y no tratado aparecieron asociados con un pronóstico significativamente peor.
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Salo, J.A., Perhoniemi, V.J., Lepäntalo, M.J.A. et al. Prognosis of patients over 75 years of age with a ruptured abdominal aortic aneurysm. World J. Surg. 13, 484–486 (1989). https://doi.org/10.1007/BF01660764
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DOI: https://doi.org/10.1007/BF01660764