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. 2016 Dec;40(12):3080-3087.
doi: 10.1007/s00268-016-3705-9.

A Majority of Admitted Patients With Ruptured Abdominal Aortic Aneurysm Undergo and Survive Corrective Treatment: A Population-Based Retrospective Cohort Study

R Hultgren  1   2 , Sayid Zommorodi  3 , Moa Gambe  4 , Joy Roy  4   5
Affiliations

A Majority of Admitted Patients With Ruptured Abdominal Aortic Aneurysm Undergo and Survive Corrective Treatment: A Population-Based Retrospective Cohort Study

R Hultgren et al. World J Surg. 2016 Dec.

Abstract

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.

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Conflict of interest statement

Compliance with ethical standards Conflicts of interest None.

Figures

Fig. 1
Fig. 1
Annual number of elective and ruptured patients treated in Sweden 2005–2013, from SWEDVASC, changes in the Web-based program was performed in 2008, which influences the number of all registered cases
Fig. 2
Fig. 2
All admitted patients with rAAA, and mortality within 30 days for all women and men during 2009–2013. Red boxes show surviving patients, gray boxes show the deceased. *percent of treated cohort, n = 212
Fig. 3
Fig. 3
Annual number of untreated and treated patients, and the number of treated patients with EVAR or OR 2009–2013
See this image and copyright information in PMC

References

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