We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Ruptured Abdominal Aortic Aneurysm: Factors Affecting Survival and Long-Term Results.
- Authors
Rosenthal, David; McKinsey, James F.; Erdoes, Luke S.; Hungerpillar, John C.; Clark, Michael D.; Lamis, Pano A.; Whitehead, Travis; Pallos, L. Laszlo
- Abstract
Although elective resection of an abdominal aortic aneurysm (AAA) is now a safe operation, the mortality related to a ruptured abdominal aortic aneurysm (rAAA) remains significant. To evaluate factors affecting survival and the long-term results after rAAA, a ten-year review of 47 patients was performed. The operative mortality rate was 43% (20/47) compared with 2.6% for 147 elective AAA patients during this period. Factors adversely affecting survival were blood pressure Lt;90 mmHg on arrival to the hospital, perioperative cardiac arrest, delay in time from diagnosis to treatment > six hours, age > seventy-five years, massive transfusion, and free intraperitoneal rupture. In follow-up extending to five years the survivors of rAAA at one (92%) and five (53%) years had no discernible differences in quality of life or long-term survival compared with age- and sex-matched patients who had elective AAA resection during the same time interval. When an rAAA occurs and any three of the adverse variables noted above are present, the mortality rate exceeds 90%. These patients remained ventilator dependent and in the ICU from one to sixty-seven days, accumulating hospital charges from $7,000 to $214,000. It appears that the most effective means of reducing mortality statistics in this inordinately low-salvage, yet high-cost subgroup of patients, is to prevent rupture of an AAA by elective resection.
- Subjects
AORTIC aneurysms; CARDIAC arrest; BLOOD transfusion; MEDICAL care costs; SURGICAL excision
- Publication
Vascular Surgery, 1992, Vol 26, Issue 1, p53
- ISSN
0042-2835
- Publication type
Article
- DOI
10.1177/153857449202600109