Ruptured Abdominal Aortic Aneurysms in Southern Saskatchewan: A 10-Year Mortality Review

Abstract

The Regina Qu'Appelle Health Region (RQHR) provides all tertiary vascular care for southern Saskatchewan and portions of southwestern Manitoba. The present study was undertaken to determine the regional mortality rates following rupture of an abdominal aortic aneurysm and to compare these rates with the published literature. A retrospective chart review was undertaken on all cases of ruptured abdominal aortic aneurysms (rAAA) presenting to the RQHR between March 1, 1996, and February 28, 2006. The demographic data and clinical outcomes were collected from hospital charts by a single reviewer. Over the 10-year study period, 101 cases of rAAA were presented to the RQHR. Patient demographics and comorbidities were comparable to other studies in the published literature. Thirty-seven percent of patients presented with systolic blood pressure below 90 mm Hg, and 7% had no recordable blood pressure. The overall mortality was 25%. Mortality risk was not statistically different between patients presenting within Regina (30%) and those referred from a distance of more than 35 km (21%, P = .353). Seven patients were treated palliatively, and 94 proceeded to open surgical repair. Within the group of patients undergoing surgery, there was a 19% mortality rate. The data show a low observed mortality rate for rAAA presenting to the RQHR. The favorable outcome of the patients is not associated with preselection bias of patients transported long distances to specialist vascular care.

Geographic disparities in the burden of ruptured and unruptured abdominal aortic aneurysms

“…However, this pattern is not seen in centers with similar relations to the Saskatoon Health Region; furthermore, a recent analysis of 10 years of ruptured AAA presenting to the Regina Qu'Appelle Health Region did not show a correlation between distant transport and death or adverse outcomes after AAA rupture. 27 The findings from the Registered Indian Status cohort are worthy of mention (Registered Indian Status does not account for all First Nations in Canada because Inuit and Metis are not considered Status Indian under the Indian Act; however, in this study we used this metric as a broad identifier of First Nations heritage). There are several potential possibilities that could explain the low incidence of AAA diagnosed in this population: First, detection and referral bias may result in a lower number of patients accessing care, especially in rural or remote areas, and subsequently receiving a diagnosis of AAA.…”