Outcome in Patients Requiring Renal Replacement Therapy After Open Surgical Repair for Ruptured Abdominal Aortic Aneurysm

Objective: To determine the relationship between postoperative renal replacement therapy (RRT) and patient survival after open surgical repair (OR) of ruptured abdominal aortic aneurysm (rAAA). Methods: A retrospective review of consecutive patients who underwent OR for rAAA repair between January 2002 and July 2008 was performed. Early (< 30days) and late (> 30days) outcomes were assessed. Results: A total of 94 patients (69 men; median [range] age 73.8 [56-89] years) underwent OR of rAAA (infrarenal = 78, juxtarenal = 15, and suprarenal = 1). In-hospital mortality rate was 40% and mean (range) length of intensive care unit (ICU) stay was 9.3 (0-56) days. A total of 23 (24%) patients required postoperative RRT. In-hospital mortality rate was significantly higher (RRT: 87% (20 of 23) vs no RRT: 18 of 71 (25%), P < .0001) and ICU stay significantly longer (RRT: mean (range) days; 14.8 (1-44) vs no RRT: 7.5 (0-56), P = .04) in the RRT patients. On multivariate analysis, RRT (P = .0053) and/or inotropic support (P = .0033) were independent risk factors for death within 30 days of the index procedure. Conclusions: Renal replacement therapy following OR of rAAA is an independent risk factor for mortality.