The "stable" ruptured abdominal aortic aneurysm gives a false sense of security

BACKGROUND: Operative mortality for ruptured abdominal aortic aneurysms (rA AA) has not changed over the past 4 decades. Previous studies have attempte d to identify preoperative risk factors that impact upon survival. METHOD: A retrospective review of 25 patients with rAAA treated during a a- year period was performed. Patients were divided into groups based upon the presence (GpI), absence (GpIIa), or subsequent development of preoperative hypotension (GpIIb), Time intervals from initial presentation to arrival i n the operating room (IP-OR), to cross clamp application (IP-XC), and from observed hypotension to cross clamp (HYPO-XC) were recorded. RESULTS: Average time intervals for IP-OR and IP-XC were significantly shor ter for GpI compared with GpIIa and GpIIb. No difference in HYPO-XC was not ed between GpI and GpIIb. Mortality was 33% for GpI, 25% for GpIIa, and 87. 5% for GpIIb. CONCLUSIONS: Normal admission blood pressure led to a decreased sense of ur gency, creating avoidable delays and missed opportunities for salvage. Am J Surg. 1999;178:133-135. (C) 1999 by Excerpta Medica, Inc.