School of Medicine

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Browsing School of Medicine by Author "Abate,Ananya (MD)"

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    Overview of Patients,Perioperative Care and Outcome of Aortic Aneurism Repair in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2024) Kebede,Tensaye; Abate,Ananya (MD); Habulu,Bonsa (MD)
    Background: Open aortic aneurism repair is a high-risk surgery with significant perioperative morbidity and mortality. There are no studies previously done in Ethiopia on this topic. Objective: This study aims to describe patient characteristics, perioperative care, and outcomes of patients undergoing open aortic aneurysm repair in Tikur Anbessa Specialized Hospital, Ethiopia. Method: A retrospective observational study of patients consecutively operated between January 2017, and May 2024, was performed. We characterized patients, perioperative care, and outcomes. Results: During the study period, 50 patients underwent aortic aneurysm repair 5 patients were excluded, from the 45 cases that were included the majority were elective cases (88.9%). 5(11.1%) were ruptured aortic aneurysm repair (2 descending thoracic and 3 infrarenal abdominal aortic aneurysm). The mean age was 54.74 years, with a range from 17 to 76 years. 33.3% were age above 65 years. The commonest site was an infrarenal abdominal aortic aneurysm (n=36, 80%) followed by suprarenal and descending thoracic aneurysms (n=3, 6.7%) both. Preoperative comorbidities included chronic hypertension (48.9%), asthma (8.9%), valvular heart disease (13.3%), diabetes mellitus (4.4%), heart failure (4.4%), and ischemic heart disease (8.9%). Most patients were on beta-blockers preoperatively (81%), and some were smokers (7.1%). Intraoperative management involved general anesthesia using endotracheal tubes, with propofol (76.2%) and fentanyl (73.8%) being common induction agents and isoflurane (88.1%) as the main inhalational agent for maintenance. The mean estimated blood loss was 1498.21 ml, and patients received an average of 3321.43 ml of crystalloid. 39(86.6%) patients were transfused intraoperatively, 25 with only PRBC and 11 PRBC with FFP and platelets, 3 with PRBC and FFP. The mean diameter of aortic aneurysms was 6.4±1.6 cm. Postoperative care included transfer to the ICU, with a mean length of stay of 4.07±3.36 days. The most common complications were acute kidney injury (21.4%) and respiratory (16.7%). 6(13.3 %) patients had in-hospital death 4 of which were male, 2(33.4%) are age > 65. The factor associated with AKI is cross-clamp time >90 minutes. Ischemic heart disease was associated with respiratory complications and in-hospital mortality (p 0.038, AOR 35.7). Conclusion: This study has extensively described patient demographics, perioperative practices, and postoperative outcomes of patients undergoing aortic aneurysm repair in this hospital. Noteworthy differences in patient demographics compared to other settings, alongside a comparatively higher mortality rates than western setups, highlight areas warranting further exploration.