Open AccessA Majority of Admitted Patients With Ruptured Abdominal Aortic Aneurysm Undergo and Survive Corrective Treatment: A Population‐Based Retrospective Cohort Study
Author(s) -
Hultgren R.,
Zommorodi Sayid,
Gambe Moa,
Roy Joy
Publication year - 2016
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-016-3705-9
Subject(s) - medicine , asymptomatic , abdominal surgery , retrospective cohort study , abdominal aortic aneurysm , vascular surgery , surgery , cohort , cardiac surgery , population , mortality rate , cardiothoracic surgery , aneurysm , aortic aneurysm , cohort study , environmental health
Background Abdominal aortic aneurysm (AAA) is an asymptomatic, potentially lethal condition predominantly found in elderly. The mortality is 100 % if rupture occurs and left untreated, but even in treated patients the mortality is substantial. Female sex and treatment with open repair rather than endovascular aortic repair (EVAR) have been reported to negatively affect outcome. The objective was to describe the contemporary care and outcome of all treated and untreated patients with ruptured AAA (rAAA) admitted to hospital. Method Population‐based retrospective investigation, including all patients admitted to the emergency departments within Stockholm County diagnosed with rAAA 2009–2013. All identified patients’ charts ( n = 297) were analyzed; the study cohort includes 283 verified patients. Results Men were in majority [214 (76 %), 69 (24 %) women] and were younger than women (78 vs 82 years, p < 0.001). A majority of patients were treated (212/283, 75 %), a similar proportion of women and men. Untreated patients had a higher mean age (84 vs 77 years, p < 0.001). The proportion treated with EVAR was 27 %, and they were older than OR treated (79 vs 76 years, p = 0.043). Forty‐seven percentage of patients admitted with rAAA survived 30 days, and 62 % of treated patients survived 30 days. The 30‐day mortality for women and men was similar. Conclusions Our results and other contemporary series show a shift toward a higher rate of treated patients with rAAA, and improving outcomes, similar for women and men. The increased use of EVAR contributes to this improvement in short‐term outcome. High age influences the willingness to treat patients with rAAA.