ASSOCIATED FACTORS FOR MORTALITY IN ACUTE RUPTURE OF ABDOMINAL AORTIC ANEURYSMS: A MULTICENTER COHORT STUDY IN COLOMBIA

Objective Ruptured abdominal aortic aneurysms (rAAAs) are a surgical challenge. Literature regarding the demographic, clinical and surgical characteristics related to mortality in the Latin-American population are scarce. This study aimed to characterize patients with rAAAs from six Colombian cities and to analyze clinical and demographic factors associated with perioperative mortality. Methods This is a multicenter retrospective cohort study. We included all patients who underwent surgical repair of rAAAs, either endovascular or open, in six Colombian cities between 2012 and 2023. Only high-volume medical centers were included. Mortality was evaluated after 24 hours and 30 days. Initial bivariate analyses were performed, and a final logistic regression model was performed between preoperative and surgical variables (age, comorbidities, cardiac arrest, creatinine value, open abdomen, intestinal ischemia) and 30-day mortality. Statistical significance was accepted if p-value < 0.2 for bivariate analysis and p < 0.05 for logistic regression. Results A total of 328 patients from 12 high-volume medical centers in Colombia were included. Most patients were male (80.18%, n=263). The open surgical approach was the most common, performed in 76.76% of the patients (n=251). In most cases, patients required admission to the intensive care unit (87.20%, n = 286). The 30-day mortality rate was 45.43% (n=149). In our analysis, several factors were significantly associated with mortality: older age (OR 1.03, 95% CI 1.01-1.06), chronic kidney disease (OR 2.40, 95% CI 1.39-4.13), higher preoperative creatinine value (OR 1.67, 95% CI 1.18-2.37), open abdomen (OR 2.02, 95% CI 1.20-3.43), and associated intestinal ischemia (OR 2.85, 95% CI 1.19-6.84). Conclusions According to our study, patients with chronic kidney disease, intestinal ischemia, and open abdomen had an increased risk for mortality. In contrast, preoperative serum lactate, pH, heart rate, and cardiac arrest in the emergency room were not statistically associated with mortality.