title: Results of streamlined regional ambulance transport and subsequent treatment of acute abdominal aortic aneurysms.
abstract: OBJECTIVE
  To describe the triage of patients operated for non-ruptured and ruptured abdominal aortic aneurysms (AAAs) before the endovascular era.
  
  
  METHODS
  Retrospective single-centre cohort study.
  
  
  METHODS
  All patients treated for an acute AAA between 1998 and 2001 and admitted to our hospital were evaluated in the emergency department for urgent AAA surgery. All time intervals, from the telephone call from the patient to the ambulance department, to the arrival of the patient in the operating theatre, were analysed. Intraoperative, hospital and 1-year survival were determined.
  
  
  RESULTS
  160 patients with an acute AAA were transported to our hospital. Mean (SD) age was 71 (8) years, and 138 (86%) were men. 34 (21%) of these patients had symptomatic, non-ruptured AAA (sAAA) and 126 patients had ruptured AAA (rAAA). All patients with sAAA and 98% of patients with rAAA were operated upon. For the patients with rAAA, median time from telephone call to arrival at the hospital was 43 min (interquartile range 33-53 min) and median time from arrival at the hospital to arrival at the operating room was 25 min (interquartile range 11-50 min). Intraoperative mortality was 0% for sAAA and 11% for rAAA (p = 0.042), and hospital mortality was 12% and 33%, respectively (p = 0.014).
  
  
  CONCLUSIONS
  A multidisciplinary unified strategy resulted in a rapid throughput of patients with acute AAA. Rapid transport, diagnosis and surgery resulted in favourable hospital mortality. Despite the fact that nearly all the patients were operated upon, survival was favourable compared with published data.
authors.affiliation: Department of Surgery, University Medical Centre Groningen, University of Groningen Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, The Netherlands. janwillemhaveman@gmail.com
authors.forename: J W
authors.initials: JW
authors.lastname: Haveman
authors.forename: A
authors.initials: A
authors.lastname: Karliczek
authors.forename: E L G
authors.initials: EL
authors.lastname: Verhoeven
authors.forename: I F J
authors.initials: IF
authors.lastname: Tielliu
authors.forename: R
authors.initials: R
authors.lastname: de Vos
authors.forename: J H
authors.initials: JH
authors.lastname: Zwaveling
authors.forename: J J A M
authors.initials: JJ
authors.lastname: van den Dungen
authors.forename: C J
authors.initials: CJ
authors.lastname: Zeebregts
authors.forename: M W N
authors.initials: MW
authors.lastname: Nijsten
mesh_terms: D000208:Acute Disease; D000368:Aged; D000552:Ambulances / Q000592:standards*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery*; D004630:Emergencies; D004636:Emergency Service, Hospital; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D013997:Time Factors; D016896:Treatment Outcome; D014218:Triage / Q000379:methods