title: Case series of patients with ruptured abdominal aortic aneurysm.
abstract: BACKGROUND
  Traditionally, patients with suspected ruptured abdominal aortic aneurysm (rAAA) are taken immediately for operative repair. Computed tomography (CT) has been considered contraindicated. However, with the emergence of endovascular repair, this approach to suspected rAAA could be changing.
  
  
  METHODS
  We present retrospective data in a case series of 110 patients with rAAA. Patients were managed at a single tertiary medical center over a five-year period. At this site, there was an established multidisciplinary protocol in which patients with suspected rAAA undergo CT with consideration for endovascular aortic repair (EVAR).
  
  
  RESULTS
  Our results demonstrated a mortality of 30% with our institutional protocol for CT in suspected rAAA. Comparing patients who ultimately had EVAR with open repair, those able to have endovascular aneurysm repair (EVAR) had lower mortality, shorter hospital stays for survivors, and a greater likelihood of being discharged to home than those with open repair. While survivors were more likely to have had EVAR, surviving patients were younger, had a significantly lower creatinine at presentation, and required fewer blood transfusions than those who died.
  
  
  CONCLUSIONS
  Based on this case series, an institutional approach endorsing CT for presumed rAAA appears to be reasonable. Our results suggest that EVAR may be beneficial in appropriately-selected patients and that CT may potentially facilitate superior management options for patient care.
authors.affiliation: Albany Medical Center, Department of Emergency Medicine, Albany, New York. West Virginia University Health Center, Morgantown, West Virginia.
authors.forename: Taylor
authors.initials: T
authors.lastname: Spencer
authors.affiliation: Albany Medical Center, Department of Emergency Medicine, Albany, New York. West Virginia University Health Center, Morgantown, West Virginia.
authors.forename: Rushad
authors.initials: R
authors.lastname: Juyia
authors.affiliation: Albany Medical Center, Department of Emergency Medicine, Albany, New York. West Virginia University Health Center, Morgantown, West Virginia.
authors.forename: Robyn
authors.initials: R
authors.lastname: Parks
authors.affiliation: Albany Medical Center, Department of Emergency Medicine, Albany, New York. West Virginia University Health Center, Morgantown, West Virginia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Hodapp
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery; D001019:Aortic Rupture / Q000000981:diagnostic imaging* / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002985:Clinical Protocols; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome