Background: To identify preoperative factors associated with in-hospital mortality in patients with ruptured abdominal aortic aneurysm.
Material and methods: Two hundred forty six patients admitted to a vascular surgery centre with ruptured abdominal aortic aneurysm (RAAA) were analyzed. Thirty one (12.6%) patients were not operated on. The end-points were the in-hospital mortality rate of all patients and the in-hospital mortality rate of operated patients. The influence of age, gender, distance from hospital, duration of symptoms, diameter of the aneurysm, systolic and diastolic blood pressure at admission, preoperative haemoglobin, haematocrit, erythrocytes, leukocytes, platelets, serum urea and serum creatinine on the study’s end-points was investigated.
Results: The in-hospital mortality rate of all patients was 60.6 % while the in-hospital mortality rate of operated patients was 54.8%. A shorter distance from the vascular surgery centre, lower systolic and diastolic blood pressure at admission, a lower preoperative level of haemoglobin, haematocrit, erythrocytes and platelets and higher serum urea and creatinine levels were significantly associated with the inhospital mortality rate of all patients. Similarly lower systolic and diastolic blood pressure at admission, a lower preoperative level of haemoglobin, haematocrit, erythrocyte and higher creatinine levels were significantly associated with the in-hospital mortality of operated patients. A shorter distance from the vascular surgery centre and a lower platelet count were of borderline statistical significance.
Conclusions: The severity of preoperative haemorrhagic shock significantly influences the in-hospital mortality of patients with RAAA. It seems that proper preoperative management of these patients could improve the results of treatment.