Vol 8, No 1 (2006)
Published online: 2006-03-17
Analysis of perioperative mortality rate in patients with abdominal aortic aneurysm treated at the Department of General and Vascular Surgery, Silesian Medical University in 1978-2005
Chirurgia Polska 2006;8(1):11-26.
Abstract
Background: The constant development of operative techniques as well as progress in anaesthesiology
has allowed one to treat patients with abdominal aortic aneurysm (AAA) with increasing success. The
aim of performing a scheduled AAA resection is the prophylaxis of an aneurysm rupture. Perioperative mortality as a result of a ruptured aneurysm is still high and on average amounts to 40-70%.
An analysis of perioperative mortality rates was carried out in patients with AAA treated at the Department
of General and Vascular Surgery in Katowice from 1978 to 2005. Patients with ruptured AAA as well
as those treated electively were analyzed.
Material and methods: From 1978 to 2005, 1620 patients with infrarenal AAA were treated electively. In the same period, 318 patients with ruptured AAA were operated on. In this study, treatment results in patients operated on during 1978-2005 were retrospectively evaluated. The assessment criterion was the perioperative mortality rate. Additionally, AAA treatment results divided in 3 time intervals: 1978-1990, 1991-2000, 2001-2005 were compared. The division into particular time intervals was dictated by the increasing experience of the surgical team and the introduction of new operative techniques.
Results: The mean mortality rate value in ruptured AAAs was 56.6% during 1978-2005. In non-ruptured (symptomatic and asymptomatic) AAA, the mean mortality rate value was 9% during 1978-2005. A fact worth noticing is that in 2005 the perioperative mortality rate accounted 3.7%. If patients treated with elective operation due to asymptomatic AAA were distinguished, the mortality rate was 4.4% during 1978-2005, whereas in 2005 it merely reached 1.2%.
Conclusions: The number of patients treated due to AAA is constantly increasing, which is unquestionably associated with the improvement of aneurysm detection. Yet the number of high risk patients with a large aneurysm has not decreased, which suggests the possibility of further AAA detection improvement, and what follows, the earlier beginning of treatment in patients in a better general condition, guaranteeing an improvement in treatment results.
Material and methods: From 1978 to 2005, 1620 patients with infrarenal AAA were treated electively. In the same period, 318 patients with ruptured AAA were operated on. In this study, treatment results in patients operated on during 1978-2005 were retrospectively evaluated. The assessment criterion was the perioperative mortality rate. Additionally, AAA treatment results divided in 3 time intervals: 1978-1990, 1991-2000, 2001-2005 were compared. The division into particular time intervals was dictated by the increasing experience of the surgical team and the introduction of new operative techniques.
Results: The mean mortality rate value in ruptured AAAs was 56.6% during 1978-2005. In non-ruptured (symptomatic and asymptomatic) AAA, the mean mortality rate value was 9% during 1978-2005. A fact worth noticing is that in 2005 the perioperative mortality rate accounted 3.7%. If patients treated with elective operation due to asymptomatic AAA were distinguished, the mortality rate was 4.4% during 1978-2005, whereas in 2005 it merely reached 1.2%.
Conclusions: The number of patients treated due to AAA is constantly increasing, which is unquestionably associated with the improvement of aneurysm detection. Yet the number of high risk patients with a large aneurysm has not decreased, which suggests the possibility of further AAA detection improvement, and what follows, the earlier beginning of treatment in patients in a better general condition, guaranteeing an improvement in treatment results.
Keywords: abdominal aortic aneurysmperioperative mortalityconventional operationstentgraftwrapping aneurysm
