Background. In spite of the progress in diagnosis and treatment of ruptured
abdominal aortic aneurysms (RAAA) the mortality rate still remains very hi
gh (varying from 15% to 50% according to various experiences). This study i
s aimed at analyzing the relative contribution of preoperative hemodynamic
conditions and of operative and postoperative factors to outcome of patient
s operated on for ruptured abdominal aortic aneurysms.
Methods. For this purpose a retrospective case series involving 152 patient
s operated on in emergency for RAAA, during the period 1990-1994, has been
reviewed. In this group we examined the site of rupture, the size of the an
eurysms, the presence or not of a shock condition at admission, the existen
ce of inflammatory aspects, the adopted type of prosthesis.
Results. The mortality rate was 24.3% (37 patients). In 10 patients (27%) t
he cause of death was an irreversible hemorrhagic shock. Eight patients (21
.6%) died for an intestinal infarction, In 7 patients the fatal outcome was
due to the development of an acute renal failure. Five patients (13.5%) un
derwent an acute myocardial infarction and other five a multiorgan failure.
Two patients (5.5%) eventually died for respiratory insufficiency.
Conclusions. The results of our study seem to confirm that the outcome of p
atients affected by rupture of abdominal aortic aneurysms depends not only
on the preoperative hemodynamic condition but also on the expertise of the
surgical team.