An audit of emergency abdominal aortic aneurysm repair to establish the necessity for an emergency vascular surgical rota

Mortality for emergency abdominal aortic aneurysm (AAA) repair remains high but results of specialist vascular surgeons are superior to those of gener al surgeons. A retrospective audit was performed on all patients undergoing emergency AAA repair over 53 months at one hospital to determine the neces sity for a vascular specialist on-call rota. Patients were stratified into two groups, those treated by specialist vascu lar surgeons and those treated by general surgeons. There were 37 patients in the vascular surgeon group and 36 in the general surgeon group, There wa s no significant difference between the two groups when age, sex distributi on, APACHE II score on admission, pre-operative delay and type of rupture w ere considered. The average operating time was 114.7 min in the vascular su rgeon group and 111.9 min in the general surgeon group. Total blood transfu sion requirements, and]postoperative duration of ventilation, inotrope ther apy and intensive treatment unit stay were similar in the two groups. Intra -operative, 30-day and cumulative hospital mortalities were 10.8% versus 8. 3%, 32.4% versus 38.9% and 40.5% versus 38.9% in the vascular surgeon and g eneral surgeon groups, respectively. The mortality figures compare favourably with other published series. As th e results of the two groups were similar, there is currently no need for va scular surgeons to be routinely available for acute AAA surgery at our hosp ital.