title: An audit of emergency abdominal aortic aneurysm repair to establish the necessity for an emergency vascular surgical rota.
abstract: Mortality for emergency abdominal aortic aneurysm (AAA) repair remains high but results of specialist vascular surgeons are superior to those of general surgeons. A retrospective audit was performed on all patients undergoing emergency AAA repair over 53 months at one hospital to determine the necessity for a vascular specialist on-call rota. Patients were stratified into two groups, those treated by specialist vascular surgeons and those treated by general surgeons. There were 37 patients in the vascular surgeon group and 36 in the general surgeon group. There was no significant difference between the two groups when age, sex distribution, APACHE II score on admission, pre-operative delay and type of rupture were considered. The average operating time was 114.7 min in the vascular surgeon group and 111.9 min in the general surgeon group. Total blood transfusion requirements, and postoperative duration of ventilation, inotrope therapy and intensive treatment unit stay were similar in the two groups. Intra-operative, 30-day and cumulative hospital mortalities were 10.8% versus 8.3%, 32.4% versus 38.9% and 40.5% versus 38.9% in the vascular surgeon and general surgeon groups, respectively. The mortality figures compare favourably with other published series. As the results of the two groups were similar, there is currently no need for vascular surgeons to be routinely available for acute AAA surgery at our hospital.
authors.affiliation: Derbyshire Royal Infirmary, Derby, UK. dileep.lobo@nottingham.ac.uk
authors.forename: D N
authors.initials: DN
authors.lastname: Lobo
authors.forename: A C
authors.initials: AC
authors.lastname: Riddick
authors.forename: S Y
authors.initials: SY
authors.lastname: Iftikhar
authors.forename: J R
authors.initials: JR
authors.lastname: Nash
authors.forename: K G
authors.initials: KG
authors.lastname: Callum
authors.forename: A M
authors.initials: AM
authors.lastname: Gudgeon
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D004635:Emergency Medicine / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D012189:Retrospective Studies; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000458:organization & administration*