Four-year follow up of patients with untreated abdominal aortic aneurysms.
BACKGROUND
The data in the literature are still controversial describing the outcome of patients not treated for a large abdominal aortic aneurysm (AAA) especially with significant comorbidities. We followed up patients trying to establish their long-term outcome.


METHODS
Since 1998, we have prospectively followed all patients referred to our department with AAA. A retrospective analysis was carried out selecting all patients who had an AAA larger than 5 cm, and who declined or were declined for operative repair between February 1998 and November 2001.


RESULTS
One hundred and eleven patients were included in the present study. There were 78 men and 33 women. The mean age was 80 years. At the end of the study, 65 patients (59%) were deceased. Ruptured aneurysm occurred in 27 patients (median time to rupture = 14 months) with one patient surviving an emergency repair. Thirty-nine patients died from unrelated illnesses. In the 5-5.9 cm AAA group (n = 58), out of 31 deceased patients, five (16%) have died of ruptured AAA. In the 6 cm and larger AAA group (n = 53), out of 34 deceased patients, 21 (62%) have died of ruptured AAA. There was no significant difference in survival between patients with AAA below and above 6 cm in diameter (P = 0.15).


CONCLUSIONS
In the presence of significant comorbidities, most patients with AAA less than 6 cm died from unrelated illnesses. In the larger AAA group, the likelihood of death from AAA rupture or unrelated illnesses is almost equal.
Aziz
Maged
M
Auckland District Health Board, Auckland, New Zealand. magedaziz@xtra.co.nz
Hill
Andrew A
AA
Bourchier
Russell
R
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D001019:Aortic Rupture / Q000401:mortality; D002423:Cause of Death; D015897:Comorbidity; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D012189:Retrospective Studies; D012306:Risk; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed