Impact of renal dysfunction on operative mortality following endovascular abdominal aortic aneurysm surgery

Abstract

Background: Preoperative renal dysfunction is a significant risk factor for death after open abdominal aortic aneurysm repair. The aim of this study was to determine whether renal dysfunction also affected mortality after endovascular aneurysm repair. Methods: Patients from the EUROSTAR registry were stratified into two groups: 4198 with normal renal function (creatinine less than 133 μmol/ml) and 969 with renal dysfunction (serum creatinine more than 133 μmol/ml). Patient characteristics and postoperative complications in the two groups were compared and the effect of renal dysfunction on operative mortality was analysed by multivariable regression models. Results: Patients with renal dysfunction had significantly more comorbidities, including cardiac and pulmonary impairment. Thirty-day mortality was significantly higher in the group with renal dysfunction (6.2 versus 2.0 per cent; P < 0.001). A significant increase in mortality (5.5 per cent) was also seen in patients with moderate renal dysfunction (serum creatinine 133-265 μmol/ml). After adjustment for age and other risk factors, renal dysfunction was still an independent risk factor for 30-day mortality (odds ratio 2.3, 95 per cent confidence interval 1.6 to 3.3; P < 0.001). Conclusion: Renal dysfunction was a significant and independent risk factor for death after endovascular aneurysm repair. Copyright © 2006 British Journal of Surgery Society Ltd Published by John Wiley & Sons Ltd.