[Surgical management of ruptured abdominal aortic aneurysm--diagnosis, risk factors and prognosis].
It has been observed that the number of emergency operations for ruptured abdominal aortic aneurysms (AAA) is still high, as is the corresponding mortality. With the aim to determine how pre-clinical as well as clinical factors affect survival of patients with perforated AAA, we examined the course of patients admitted with perforated AAA in the last six years. Retrospectively we assessed the following documented parameters: patient's age, pre-clinical interval between onset of symptoms and hospitalization, the preoperative circulatory situation, hospital resuscitation period before surgery, the duration of aortic cross-clamping and the need of intraoperative blood transfusions in relation to the hospital mortality. In the period between 1.1.1990-31.12.1995, 39 patients with ruptured abdominal aortic aneurysms were operated on emergency basis in the Department of General Surgery of the University of Essen. There were 36 men and 3 women. The average age was 69.1 years. 25 patients (64%) died on admission, 4 of them intraoperatively. The most relevant observed prognostic factors were the preoperative circulatory status (systolic blood pressure p < 0.0001; hemoglobin p < 0.01) as well as the intraoperative blood transfusion requirement (p < 0.01) In view of the high mortality associated with surgical treatment of ruptured AAA and with the difficulty to decisively influence the relevant prognostic factors, early elective surgery of asymptomatic patients with AAA is highly recommended.
Domínguez Fernández
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E
Abteilung für Allgemeine Chirurgie, Universitätsklinikums Essen.
Erhard
J
J
Stracke
A
A
Albrecht
K H
KH
D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001803:Blood Transfusion; D004630:Emergencies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012151:Resuscitation; D015996:Survival Rate
Chirurgische Versorgung des rupturierten Bauchaortenaneurysmas--Diagnose, Risikofaktoren und Prognose.