SURGICAL-TREATMENT OF RUPTURED ABDOMINAL AORTIC-ANEURYSM - DIAGNOSIS,RISK-FACTORS AND OUTCOME

It has been observed that the number of emergency operations for ruptu red abdominal aortic aneurysms (AAA) is still high, as is the correspo nding mortality. With the aim to determine how pre-clinical as well as clinical factors affect survival of patients with perforated AAA, we examined the course of patients admitted with perforated AAA in the la st six years. Retrospectively we assessed the following documented par ameters: patient's age, pre-clinical interval between onset of symptom s and hospitalization, the preoperative circulatory situation, hospita l resuscitation period before surgery, the duration of aortic cross-cl amping and the need of intraoperative blood transfusions in relation t o the hospital mortality. In the period between 1.1.1990-31.12.1995, 3 9 patients with ruptured abdominal aortic aneurysms were operated on e mergency basis in the Department of General Surgery of the University of Essen. There were 36 men and 3 women. The average age was 69.1 year s. 25 patients (64%) died on admission, 4 of them intraoperatively. Th e most relevant observed prognostic factors were the preoperative circ ulatory status (systolic blood pressure p < 0.0001; hemoglobin p < 0.0 1) as well as the intraoperative blood transfusion requirement. (p < 0 .01) In view of the high mortality associated with surgical treatment of ruptured AAA and with the difficulty to decisively influence the re levant prognostic factors, early elective surgery of asymptomatic pati ents with AAA is highly recommended.