Linked Life Data

9514224

Source:http://linkedlifedata.com/resource/pubmed/id/9514224

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
1998-5-7
pubmed:abstractText
The in-hospital mortality for a patient with a ruptured abdominal aortic aneurysm (RAAA) ranges from 30% to 70% and remains unchanged despite aggressive surgical, anesthetic, and intensive-care management. The purpose of this investigation is to determine the relationship between the development of organ dysfunction and mortality in ruptured AAA patients. Eighty-eight consecutive patients admitted to the Toronto Hospital for repair of RAAAs were studied. APACHE II and multiple organ dysfunction (MOD) scores were calculated for all patients. The MOD scoring system measures daily alterations in the function of six key organs, with increased dysfunction indicated by an increasing score. The overall 30-day mortality rate was 40%; 10% of patient deaths occurred intraoperatively. ICU mortality was bimodal; 11.5% deaths occurred within the first 48 hours compared to 18.2% after 48 hours (late deaths). The APACHE II score was significantly higher in those who died within 48 hours of ICU admission (28.5 +/- 6.36) compared to both those who died late (17.2 +/- 5.7, p < 0.0001) and survivors (11.2 +/- 4.2, p < 0.0001). The survivors' daily mean MOD scores did not increase significantly, while the MOD scores for late deaths increased progressively (p < 0.01). The renal and hepatic dysfunction components of the MOD score were significantly lower in the survivors compared to late deaths (p < 0.001), however the respiratory MOD score did not differ between the groups (p > 0.05). The change in MOD (delta MOD) score over the intensive care stay was significantly greater in late deaths compared to survivors (p < 0.01). The rates of infection were similar in both groups and were not responsible for mortality. We conclude that mortality is better predicted following RAAA by the development of renal and hepatic dysfunction rather than by initial physiologic derangement measured by the APACHE II score.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Mar
pubmed:issn
0890-5096
pubmed:author
pubmed:issnType
Print
pubmed:volume
12
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
93-100
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed:year
1998
pubmed:articleTitle
The impact of multiple organ dysfunction on mortality following ruptured abdominal aortic aneurysm repair.
pubmed:affiliation
The Toronto Hospital, and the Department of Surgery, University of Toronto, Ontario, Canada.
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't