BACKGROUND: Inflammation is integral to the pathogenesis of abdominal aortic aneurysm (AAA). This study examines preoperative biomarkers of systemic inflammation in patients undergoing open repair of intact and ruptured AAA. METHODS: One-hundred twelve patients were entered into a prospective observational study. Preoperative POSSUM physiology score, C-reactive protein (CRP), white blood count (WBC), platelet count, fibrinogen, and albumin were recorded and related to clinical variables using univariate analysis. RESULTS: Sixty-one patients with a ruptured AAA, 39 with an asymptomatic intact AAA, and 12 with an acutely symptomatic intact AAA underwent attempted repair. There were two inflammatory asymptomatic aneurysms and one inflammatory ruptured aneurysm. No patient had clinical evidence of coexistent inflammatory disease. Patients with a symptomatic intact AAA had a significantly greater level of CRP and fibrinogen, higher WBC, and lower serum albumin, than those with an asymptomatic intact AAA. Patients with a ruptured aneurysm had a significantly greater level of CRP, higher WBC, and lower serum albumin than those with an asymptomatic intact aneurysm. Patients with a symptomatic intact AAA had a significantly higher CRP level, but lower WBC, than those with a ruptured AAA. There was no difference in CRP level, WBC, or serum albumin between survivors and non-survivors of attempted repair of asymptomatic, symptomatic and ruptured AAA. CONCLUSIONS: Acutely symptomatic and ruptured AAAs are associated with an early elevation in systemic inflammatory biomarkers. This early activation of the inflammatory response might influence perioperative outcome.
BACKGROUND: Inflammation is integral to the pathogenesis of abdominal aortic aneurysm (AAA). This study examines preoperative biomarkers of systemic inflammation in patients undergoing open repair of intact and ruptured AAA. METHODS: One-hundred twelve patients were entered into a prospective observational study. Preoperative POSSUM physiology score, C-reactive protein (CRP), white blood count (WBC), platelet count, fibrinogen, and albumin were recorded and related to clinical variables using univariate analysis. RESULTS: Sixty-one patients with a ruptured AAA, 39 with an asymptomatic intact AAA, and 12 with an acutely symptomatic intact AAA underwent attempted repair. There were two inflammatory asymptomatic aneurysms and one inflammatory ruptured aneurysm. No patient had clinical evidence of coexistent inflammatory disease. Patients with a symptomatic intact AAA had a significantly greater level of CRP and fibrinogen, higher WBC, and lower serum albumin, than those with an asymptomatic intact AAA. Patients with a ruptured aneurysm had a significantly greater level of CRP, higher WBC, and lower serum albumin than those with an asymptomatic intact aneurysm. Patients with a symptomatic intact AAA had a significantly higher CRP level, but lower WBC, than those with a ruptured AAA. There was no difference in CRP level, WBC, or serum albumin between survivors and non-survivors of attempted repair of asymptomatic, symptomatic and ruptured AAA. CONCLUSIONS: Acutely symptomatic and ruptured AAAs are associated with an early elevation in systemic inflammatory biomarkers. This early activation of the inflammatory response might influence perioperative outcome.
Authors: J Juvonen; H M Surcel; J Satta; A M Teppo; A Bloigu; H Syrjälä; J Airaksinen; M Leinonen; P Saikku; T Juvonen Journal: Arterioscler Thromb Vasc Biol Date: 1997-11 Impact factor: 8.311
Authors: Martin Schillinger; Hans Domanovits; Keywan Bayegan; Thomas Hölzenbein; Martin Grabenwöger; Jana Thoenissen; Martin Röggla; Marcus Müllner Journal: Intensive Care Med Date: 2002-04-23 Impact factor: 17.440
Authors: Tomasz Wołoszko; Maciej Skórski; Przemysław Kwasiborski; Ewelina Kmin; Zbigniew Gałązka; Ryszard Pogorzelski Journal: Med Sci Monit Date: 2016-02-09
Authors: Bogna Gryszczyńska; Magdalena Budzyń; Dorota Formanowicz; Piotr Formanowicz; Zbigniew Krasiński; Natalia Majewska; Maria Iskra; Magdalena P Kasprzak Journal: Biomed Res Int Date: 2019-05-08 Impact factor: 3.411
Authors: Menno E Groeneveld; Jorn P Meekel; Sidney M Rubinstein; Lisanne R Merkestein; Geert Jan Tangelder; Willem Wisselink; Maarten Truijers; Kak Khee Yeung Journal: J Am Heart Assoc Date: 2018-06-30 Impact factor: 5.501