A study of the mortality from ruptured abdominal aortic aneurysms in a district community

Budd, J. S.; Finch, D. R. A.; Carter, P.G.

doi:10.1016/s0950-821x(89)80073-8

Cited by 82 publications

(34 citation statements)

References 12 publications

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“…6,7 In specialist centers, operative mortality for those undergoing elective repair of the aorta, before rupture, is between 1% and 3%. 6,8 Using the Jungger and Wilson criteria 9 for mass screening, many have advocated that screening for abdominal aortic aneurysm in the at-risk population, men aged 65 to 75 years, should be introduced in the United Kingdom. …”

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confidence: 99%

Changes in diameter of the abdominal aorta with age: An epidemiological study

Grimshaw

Thompson

1997

J. Clin. Ultrasound

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confidence: 99%

Changes in diameter of the abdominal aorta with age: An epidemiological study

Grimshaw

Thompson

1997

J. Clin. Ultrasound

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“…4) If patients who died at home or during transport to a hospital are included, the mortality rate approaches 90%. 25,26) This excessively high operative mortality rate can be explained by the facts that patient selection is usually impossible, and the majority have already suffered the consequences of hypovolemic shock at admission. Johansen et al 4) demonstrated a mortality rate of 70% in 186 patients with RAAA treated at a single hospital; this survival rate was measured despite specialized prehospital management and transport, short emergency department diagnostic evaluation, aneurysmal repair by an operating vascular surgery team, and sophisticated postoperative care.…”

Section: Discussionmentioning

confidence: 99%

Indicators of Survival after Open Repair of Ruptured Abdominal Aortic Aneurysms and an Index for Predicting Aneurysmal Rupture Potential

Takahashi

Fukui

Wada

et al. 2011

Annals of Vascular Diseases

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Introduction Despite the increased number of cases of elective abdominal aortic aneurysm (EAAA) repair, the number of patients with ruptured AAA (RAAA) has not significantly reduced in the past decade.1) Further, although the mortality rate following EAAA repair has steadily improved by about 1%-6%, 2) the mortality rate after RAAA repair has not significantly changed in the last three decades and is still in the 30%-70% range. 3, 4) Many factors, including age, comorbidity, medical condition, preoperative shock or hypotension, increased creatinine level, low hemoglobin or hematocrit level, and technical and postoperative complications, are considered predictors of death, but none of these correctly predict the outcome of patients with RAAA. 5-7)The maximum transverse aneurysmal diameter has been the only criterion used to predict aneurysmal rupture potential in the last 40 years.8) According to this criterion, aneurysms reaching 5-5.5 cm in diameter are generally recommended for repair. 9) However, there are many reports of rupture of aneurysms smaller than 5.5 cm in diameter; the estimated rupture rate of small aneurysms varies between 4.6% and 23%.10) On the other hand, the incidental presentation of extremely large asymptom- Results: The mortality rate was 18.6% (8/43). The ratio between the maximum aneurysmal diameter and the length (along the central axis) from the aneurysmal neck to the point at which the diameter was threefourth of the maximum aneurysmal diameter was used as an index to predict aneurysmal rupture potential. The index score was 2.7 ± 1.2 in the RAAA and 1.9 ± 0.9 in the EAAA (p = 0.018). For aneurysms of ≤ 6-cm diameter, the index score was 3.0 ± 1.0 in the RAAA and 1.8 ± 0.9 in the EAAA (p = 0.03). All patients in the EAAA except one had an index score of < 2.3 and 6 of the 7 patients with RAAA had a score of > 3. Indicators of Survival after Open Repair of Ruptured Conclusions:The results suggest that patients with AAA having scores of > 3 are at high risk of rupture. This index would be useful for decision making regarding repair of AAA, especially in the borderline cases.

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“…2 The reported overall risk of death at the time of rupture of an AAA ranges from 79 to 94%. [3][4][5][6][7][8][9][10][11] The anticipated magnitude of the risk of death in patients with a ruptured AAA is an important factor in the decision to perform surgery in patients with AAA. Older age, female gender, and diameter of the AAA have been reported to be independent and significant risk factors for mortality after ruptured AAA repair.…”

Section: Introductionmentioning

confidence: 99%