Elective abdominal aortic aneurysm operations--the results of a single surgeon series of 243 consecutive operations from a district general hospital.
BACKGROUND
There are few data on the morbidity and mortality of planned elective surgery for infrarenal abdominal aortic aneurysm (AAA) as a single surgeon series. This audit is of a consecutive series of AAA operations performed by one surgeon in one district general hospital over a 13-year period.


METHODS
243 patients were operated on for AAA between 1985 and 1998. Data were collected on the majority of patients prospectively. A reliable method was devised to identify all patients. Any missing complication and mortality data were then collected retrospectively.


RESULTS
13 patients died as a result of their operation (5.3%). In patients over the age of 80 years (36), five patients died (14%) and in the 207 patients under the age of 80 years, eight died (3.8%). Cardiac deaths were the most frequent cause (38%); 82 patients had recorded complications (34%). The operative mortality rate has increased in later years, (2.2% to 7.1%), largely due to an increase in the very elderly accepted for operation (12% to 16%), and a possible increase in co-morbidity.


CONCLUSIONS
An acceptable and comparable mortality rate can be achieved in a district general hospital. The complication rate is high indicating the need for very intense medical and nursing care for these patients postoperatively. There is a considerable variance in mortality rates with age and risk even in the practice of one surgeon, indicating a need to be very knowledgeable and cautious in interpreting postoperative mortality data. This is the largest single surgeon series to date in the UK.
Humphreys
W V
WV
Department of Vascular Surgery and Anaesthetics, Ysbyty Gwynedd, Bangor, Gwynedd, UK.
Byrne
J
J
James
W
W
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D005260:Female; D006767:Hospitals, District; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome; D014852:Wales / Q000453:epidemiology