The Prognostic Factors of 30-Day Mortality of Ruptured Abdominal Aortic Aneurysm After Endovascular Treatment

Purpose: To analyze the prognostic factors related to the mortality of ruptured abdominal aortic aneurysm (AAA) after endovascular treatment

Materials and Methods: Fourteen patients who sustained a ruptured abdominal aortic aneurysm (rAAA) and were treated by endovascular treatment in the period between September 2012 and July 2018 were retrospectively analyzed. Information on demographic characteristics, including age and gender, was recorded, and medical data such as diabetes mellitus, hypertension, dyslipidemia, chronic obstructive pulmonary disease (COPD), smoking, lowest systolic blood pressure in the emergency department (ED), time from symptom onset to arrival in the ED, time from arrival in the ED to the operation room, initial hemoglobin, immediate endoleak, diameter of rAAA, hostile neck of rAAA, and 30-day survival, were obtained. Descriptive statistics, mean, and standard deviation were computed for continuous variables, and statistical significance was tested by Mann-Whitney U-test. Categorical variables were described by frequency distribution and percentages; Fisher’s exact test was used to test for statistical significance.

Results: Five (36%) patients died within 30 days after endovascular treatment. Four patients had an immediate endoleak in the expired group. No immediate endoleaks occurred in the survival group, and the difference in endoleak rates between the expired and survival groups was statistically significant (P = 0.005). There was no significant difference of diabetes mellitus, hypertension, dyslipidemia, COPD, smoking, lowest systolic blood pressure in the ED, time from symptom onset to arrival in the ED, time from arrival in the ED to the operation room, initial hemoglobin, immediate endoleak, diameter of rAAA, or hostile neck of rAAA between the expired and survival groups (P = 1.000, 0.110, 1.000, 1.000, 0.505, 0.364, 0.518, 0.797, 0.240, 0.258, 0.298, and 1.000, respectively).

Conclusions: Immediate endoleaks have a significant effect on the mortality rate within 30 days after endovascular treatment.