Mesenteric ischemia risk factors after abdominal aortic aneurysm repair

Abstract

Objectives The aim of this retrospective study was to identify the independent risk factors predicting mesenteric ischemia after abdominal aortic aneurysm repair. Materials and Methods A retrospective study analysed 340 patients undergoing abdominal aorta aneurysm (AAA) repair at the Vascular surgery and Surgery Clinics of Lithuanian University of Health Sciences hospital between 2009 and 2019. All the patients were divided into two groups: patients with and without postoperative mesenteric ischemia. The patient – operation related factors included age, gender, the American Society of Anesthesiologists (ASA) functional class, body mass index (BMI), the urgency of operation, intact or ruptured AAA, shock before the operation (AKS systolic<90mmHg), blood loss, aorta clamping time, duration of the operation and operation technique. Chi square test was used for categorical data and Mann Whitney test - to compare nonparametric values. Roc curve and multivariable logistic regression analysis was used to identify the independent predictors for postoperative mesenteric ischemia. Significance was set at the p<0.05. Results 340 patients case histories were analyzed. The average age was 71.8 ± 8.8, most patients were males (86.2 %). All patients underwent invasive treatment for AAA (open 71.2%; endoscopic (EVAR) 28.8%), of which 86 (25.3%) were diagnosed with ruptured AAA. Mesenteric ishemia ocurred in 22 (6.5%) patients, of which 18 (81.8%) died. Mortality rate was 5.3%. The first group with mesenteric ischemia - 22 (6.5%) patients and the second group – without mesenteric ischemia - 318 (93.5%) patients. There was significant difference between I and II patient groups in age: (78±7.3 vs 71.4±8.7, p=0.001); ASA class groups: ASA (2-3 group) - 3 (13.6%) vs 205 (65.3%), p=0.001; ASA (4-5 group): 19 (8.6%) vs 109 (34.7%), p=0.001; type of operation: emergency: 15 (68.2%) vs 83 (26.1%), p=0.002; elective surgery: 7 ([...].