Editor's Choice - Abdominal Compartment Syndrome After Surgery for Abdominal Aortic Aneurysm: A Nationwide Population Based Study

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Ersryd, SamuelUppsala universitet,Kärlkirurgi,Centrum för klinisk forskning, Gävleborg (författare)

Editor's Choice - Abdominal Compartment Syndrome After Surgery for Abdominal Aortic Aneurysm : A Nationwide Population Based Study

Artikel/kapitelEngelska2016

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Elsevier BV,2016
electronicrdacarrier

Nummerbeteckningar

LIBRIS-ID:oai:DiVA.org:uu-307899
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-307899URI
https://doi.org/10.1016/j.ejvs.2016.03.011DOI

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Språk:engelska
Sammanfattning på:engelska

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Objective/Background: The understanding of abdominal compartment syndrome (ACS), and its importance for outcome, has increased over time. The aim was to investigate the incidence and clinical consequences of ACS after open (OR) and endovascular repair (EVAR) for ruptured and intact infrarenal abdominal aortic aneurysm (rAAA and iAAA, respectively). Methods: In 2008, ACS and decompression laparotomy (DL) were introduced as variables in the Swedish vascular registry (Swedvasc), offering an opportunity to study this complication in a prospective, population based design. Operations carried out in the period 2008-13 were analysed. Of 6,612 operations, 1,341 (20.3%) were for rAAA (72.0% OR) and 5,271 (79.7%) for iAAA (41.9% OR). In all, 3,171 (48.0%) were operated on by OR and 3,441 by EVAR. Prophylactic open abdomen (OA) treatment was validated through case records. Cross-matching with the national population registry secured valid mortality data. Results: After rAAA repair, ACS developed in 6.8% after OR versus 6.9% after EVAR (p = 1.0). All major complications were more common after ACS (p<.001). Prophylactic OA was performed in 10.7% of patients after OR. For ACS, DL was performed in 77.3% after OR and 84.6% after EVAR (p=.433). The 30 day mortality rate was 42.4% with ACS and 23.5% without ACS (p <.001); at 1 year it was 50.7% versus 31.8% (p <.001). After iAAA repair, ACS developed in 1.6% of patients after OR versus 0.5% after EVAR (p <.001). Among those with ACS, DL was performed in 68.6% after OR and in 25.0% after EVAR (p=.006). Thirty day mortality was 11.5% with ACS versus 1.8% without it (p <.001); at 1 year it was 27.5% versus 6.3% (p <.001). When ACS developed, renal failure, multiple organ failure, intestinal ischaemia, and prolonged intensive care were much more frequent (p <.001). Morbidity and mortality were similar, regardless of primary surgical technique (OR/EVAR/iAAA/rAAA). Conclusion: ACS and OA were common after treatment for rAAA. ACS is a devastating complication after surgery for rAAA and iAAA, irrespective of operative technique, emphasizing the importance of prevention.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
Abdominal compartment syndrome
Open abdomen treatment
Aortic aneurysm-abdominal
Rupture
Population-based design
Registry

Biuppslag (personer, institutioner, konferenser, titlar ...)

Djavani-Gidlund, KhaterehUppsala universitet,Kärlkirurgi,Centrum för klinisk forskning, Gävleborg(Swepub:uu)khadj328 (författare)
Wanhainen, AndersUppsala universitet,Kärlkirurgi(Swepub:uu)anwan103 (författare)
Björck, MartinUppsala universitet,Kärlkirurgi(Swepub:uu)mabjo425 (författare)
Uppsala universitetKärlkirurgi (creator_code:org_t)

Sammanhörande titlar

Ingår i:European Journal of Vascular and Endovascular Surgery: Elsevier BV52:2, s. 158-1651078-58841532-2165

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European Journal of Vascular and Endovascular Surgery (Sök värdpublikationen i LIBRIS)

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Av författaren/redakt...: Ersryd, Samuel; Djavani-Gidlund, ...; Wanhainen, Ander ...; Björck, Martin

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kardiologi

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kirurgi

Artiklar i publikationen: European Journal ...

Av lärosätet: Uppsala universitet

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