Mortality in ruptured abdominal aortic aneurysms

Objective: to assess mortality related to rupture of abdominal aortic aneur ysm (RAAA). Design: a 4-year cross-sectional study based on a nationwide vascular regis try Finnvasc and national cause-of-death registry (Statistics Finland). Materials and methods: a total of 454 operations for RAAA among 11 747 surg ical vascular reconstructions recorded in the Finnvasc registry and 1004 de aths due to RAAA during the same period based on Statistics Finland. Results: the operative mortality rate was 49% based on the Finnvasc registr y and 54% based on Statistics Finland. With all RAAA deaths at hospitals in cluded, total hospital mortality was 68%. No association existed between ho spital volume of RAAA operations and surgical mortality, although an invers e association did exist between hospital volume of RAAA operations and all RAAA deaths in the hospital (p = 0.01). The case fatality for RAAA in Finla nd was 80%. Conclusions: RAAA surgical mortality calculations for RAAA, based on a vasc ular registry, underestimate the true rate because some cases with fatal ou tcome tend to escape registration. Because surgical mortality rates may als o be skewed by patient selection, total hospital RAAA mortality thus repres ents the results of RAAA treatment more accurately.