A PROSPECTIVE SURVEY OF PATIENTS PRESENTING WITH ABDOMINAL AORTIC-ANEURYSM

Objectives: To define the presentation and management of patients pres enting with abdominal aortic aneurysm (AAA) Design and setting: A pros pective survey was carried out of all patients presenting to hospitals within the Oxford region. Materials and methods: Data were collected by one surgeon in each hospital. Full details were collected onto data sheets. Results: One hundred and ninety patients presented, 141 elect ively, 46 with ruptured AAA and three with acute AAAs. In 53 patients presenting electively the aneurysm was small and surveillance started. Fifty-six patients underwent an operation, three patients died. Of 46 patients with a ruptured aneurysm 24 (52%) died. In 11 no operation w as carried out and all of these patients died within 24 h. Operative m ortality was 13 of 35 patients (37%). Move patients with a ruptured AA A were transferred to the teaching hospital compared with a district g eneral hospital (p<0.05). This was reflected in a lower operative mort ality in the teaching hospital. Conclusions: The presentation of AAA i n this study was approximately 15 per 100000 population. Approximately one-third of patients presenting electively had small AAAs which requ ired surveillance. A further third underwent an operation, the remaini ng patients being unfit. Approximately one-quarter of patients with a ruptured aneurysm did not undergo an operation. The operative mortalit y was 37%.