title: Population-based survival rate with a one- or two-stop referral pattern for patients with ruptured abdominal aortic aneurysms.
abstract: OBJECTIVE
  Is there a difference in the population-based survival rate for patients with ruptured abdominal aortic aneurysms (rAAA), handled by a "one-stop" or a "two-stop" referral pattern?
  
  
  METHODS
  Ten regions in Sweden were identified where clear-cut "one-stop" or "two-stop" referral-patterns prevailed. From the Swedvasc Registry we identified 849 patients operated on for rAAA, 1987 to 2004, living in any of these ten regions, and related the number of survivors to the whole population served by each hospital.
  
  
  RESULTS
  The population-based survival rate was 14% lower for patients following a "two-stop" compared to a "one-stop" referral pattern (P=0.084). For the group 65-74 years-of-age the difference was significant (P=0.021), but no corresponding effect was seen regarding operative mortality rate or sex.
  
  
  CONCLUSIONS
  Compared to a "one-stop" referral pattern for rAAA, a "two-stop" referral pattern results in a lower population-based survival rate for patients 65-74 years old, but the consequences would be small even if a "one-stop" referral pattern could be generally accomplished.
authors.affiliation: Department of Thoracic and Vascular surgery, The University Hospital, SE-58185 Linköping, Sweden. Jakob.Hager@Lio.se
authors.forename: J
authors.initials: J
authors.lastname: Hager
authors.forename: F
authors.initials: F
authors.lastname: Lundgren
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D001019:Aortic Rupture / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D002391:Catchment Area, Health; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation; D012042:Registries; D016019:Survival Analysis; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome