Elective surgery >> Comorbidities
The large number of patients with cardiac and respiratory symptoms confirms the expectation of finding comorbidity in patients with abdominal aneurysms, especially hypertension and coronary artery disease. A history of heart failure more than one month before surgery was associated with a mortality rate of 21%. Few patients admitted for elective surgery had cardiac signs on admission but the presence of peripheral oedema was associated with a higher mortality. The presence of dyspnoea on exertion (a symptom associated with respiratory and cardiac disease) was also associated with an increase in mortality rate. Interestingly the presence of atrial fibrillation was not associated with increased risk of death although the number of cases was small. A large number of patients were classified as having other unspecified abnormalities on their ECG. However, the responses to this question by the surgeon may have been based on their own interpretation of the ECG or on a computerised analysis.
Table 2. Cardiac history in elective patients and their outcome n=434.
Answers may be multiple. |
| Cardiac history |
Total |
% that died within 30 days |
| None |
134 |
7 |
| Angina controlled/on exertion |
93 |
9 |
| Heart failure more than one month ago |
14 |
21 |
| Hypertension |
179 |
6 |
| MI more than two months ago |
107 |
7 |
| Other |
68 |
40 |
| Unknown |
1 |
|
| Not answered |
2 |
|
Table 3. Cardiac signs in elective patients n=434.
Answers may be multiple. |
| Cardiac signs |
Total |
% that died within 30 days |
| None |
362 |
6 |
| Peripheral oedema |
21 |
14 |
| Other |
49 |
8 |
| Unknown |
7 |
|
| Not answered |
7 |
|
Table 4. ECG and outcome n=434.
Answers may be multiple. |
| ECG |
Total |
% that died within 30 days |
| None |
243 |
5 |
| AF rate >90 |
20 |
<1 |
| Other abnormality |
145 |
9 |
| Not answered |
2 |
|
Table 5. Respiratory history and outcome n=434.
Answers may be multiple. |
| Respiratory history |
Total |
% that died within 30 days |
| None |
295 |
4 |
| Dyspnoea on exertion |
113 |
11 |
| Dyspnoea at rest |
2 |
<1 |
| Other |
12 |
<1 |
| Not answered |
4 |
|
9% (39/423) of patients were diabetic which is in line with previous knowledge that diabetes is a common comorbidity in people with vascular disease. However, in this study the presence of diabetes was not associated with an increased mortality. The 30 day mortality for patients considered to have a normal build was 5% (21/382). 28 patients were considered to be morbidly obese (30 day mortality 11%) and five were cachectic (30 day mortality 20%).
Back to top
|
