• Jannie Bisgaard, Torben Gilsaa, Ebbe Rønholm, and Palle Toft.
• Department of Anaesthesia and Intensive Care, Lillebaelt Hospital Kolding, Kolding, Odense University Hospital, Odense, Denmark. janniebisgaard@hotmail.com
• Eur J Anaesthesiol. 2013 Feb 1;30(2):65-72.

ContextAbdominal aortic surgery is a high-risk procedure, with aortic aneurysm and aortic occlusive diseases being the main indications. These groups are often regarded as having equal perioperative risk profiles. Previous reports suggest that the haemodynamic and inflammatory response to aortic clamping is more pronounced in patients with aortic aneurysm disease, which may affect outcome.ObjectivesThe aim of this observational cohort study was to evaluate outcome after open elective abdominal aortic surgery, hypothesising a higher 30-day mortality, a higher incidence of postoperative organ dysfunction and a longer length of stay in patients with aortic aneurysm compared with aortic occlusive disease.DesignCohort observational study based on prospective registrations from national databases.SettingEight Danish hospitals, including four university and four non-university centres, from 1 January 2007 to 1 March 2010.PatientsOne thousand two hundred and ninety-three patients scheduled for primary open elective, aortoiliac bypass or aortofemoral bypass procedures or abdominal aortic aneurysm repair.Main Outcome MeasuresMechanical ventilation, acute dialysis, use of vasopressors or inotropes, ICU stay more than 24 h, hospital length of stay and mortality.ResultsCompared with aortic occlusive disease, more patients with aortic aneurysm disease had ICU stays more than 24 h (62 vs. 45%, P < 0.001) and more often needed acute dialysis or ventilatory support (17 vs. 11%, P = 0.04). No difference was found in hospital length of stay, 30-day mortality or overall risk of death. Mortality after 1 year was higher in patients with aortic aneurysm disease (8 vs. 4.7%, P = 0.04).ConclusionPatients with abdominal aortic aneurysms were at higher risk of developing postoperative organ dysfunction and required more ICU resources than patients with occlusive disease, despite no differences in hospital length of stay or 30-day mortality. Distinguishing between these two diseases may be useful in planning and distribution of ICU resources and for in future studies.

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