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Khirurgii

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Year 2013 Vol. 21 No 4

GENERAL AND SPECIAL SURGERY

V.JA. KHRYSHCHANOVICH1, S.I. TRETYAK1, I.P. KLIMCHUK2, A.D. AVDIEVICH2, A.V. ROMANOVICH2, E.R. SHAGISULTANOV2, G.A. POPEL3, A.V. BOLSHOV1, G.V. GERASIMOVICH1

RUPTURE OF ABDOMINAL AORTIC ANEURISM: PROGNOSTIC FACTORS OF MORTALITY

EE “Belarusian State Medical University” 1,
ME “The 4th city clinical hospital named after N.E. Savchenko”2, Minsk,
SEE “Belarusian Medical Academy of Postgraduate Education” 3,
The Republic of Belarus

Objectives. To analyze the prognostic factors influencing the postoperative mortality in patients with the ruptured of abdominal aortic aneurysm (AAA).
Methods. Thirty-nine patients operated for the rupture of AAA in Minsk city center of the vascular surgery within the period between 2007 up to January, 31, 2012 were included in the research. The retrospective analysis of the potential predictors of mortality was carried out: age, anamnesis, aneurysm diameter, creatinine and hemoglobin levels, systolic blood pressure, postoperative diuresis, transfusion volume, aortic clamping and surgery duration, type of reconstruction.
Results. General mortality rate made up 48%. An average age of all patients made up 70,7±6,8 years, the patients who died – 73±6,5 years. Previous history of the abdominal aortic aneurysm was present in 15 patients (42%) and the abdominal pain and pulsatile abdominal mass – in 100% of cases. Concentration of creatinine and hemoglobin levels, systolic blood pressure findings, postoperative daily volume of diuresis, intraoperative transfusion volume, type of surgery and its duration; hemoglobin level didn’t influence reliably the mortality rate data (p>0,05). The patient’s age > 80 years, aortic clamping duration > 80 min, aneurysm diameter > 9 cm, anuria before operation, anamnesis were the reliable prognostic factors of mortality in patients operated for AAA rupture.
Conclusions. Early diagnostics, timeous planned surgery of AAA are considered to be the most effective approaches in reduction of the mortality rate. Patients with the clinical triad: the abdominal pain and/or back pain, pulsatile mass in the abdomen and hypotension are indicated the immediate surgery.

Keywords: abdominal aortic aneurysm, ruptured aneurysm, mortality, prognosis of mortality, factors of mortality
p. 51 – 56 of the original issue
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Address for correspondence:
220116 Respublika Belarus', g. Minsk, prospekt Dzerzhinskogo, 83, UO «Belorusskii gosudarstvennyi meditsinskii universitet» 2-ia kafedra khirurgicheskikh boleznei,
e–mail: vladimirkh77@mail.ru
Khryshchanovich Vladimir Yanovich
Information about the authors:
Khryshchanovich V.Ja. PhD, an associate professor of the 2nd chair of surgical diseases of EE “Belarusian State Medical University”.
Tretyak S.I. MD, professor, Head of the 2nd chair of surgical diseases of EE “Belarusian State Medical University”.
Klimchuk I.P. PhD, a Head of the phlebology and vascular surgery department of ME “The 4th city clinical hospital named after N.E. Savchenko”.
Avdievich A.D. An angiosurgeon of ME “The 4th city clinical hospital named after N.E. Savchenko”.
Romanovich A.V. An angiosurgeon of ME “The 4th city clinical hospital named after N.E. Savchenko”.
Shagisultanov E.R. An angiosurgeon of ME “The 4th city clinical hospital named after N.E. Savchenko”.
Popel G.A. An assistant of the surgery chair of SEE “Belarusian Medical Academy of Postgraduate Education”.
Bolshov A.V. PhD, an assistant of the 2nd chair of surgical diseases of EE “Belarusian State Medical University”.
Gerasimovich G.V. A 6-year student of EE “Belarusian State Medical University”.
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