In-hospital mortality from abdominal aortic surgery in Great Britain and Ireland: Vascular Anaesthesia Society audit

Background: The mortality rate associated with elective aortic aneurysm rep air is widely assumed to be in the region of 5 per cent. This figure does n ot take into consideration the effect of pre-existing risk factors. The Vas cular Anaesthesia Society of Great Britain and Ireland conducted a large au dit to estimate the in-hospital mortality rate associated with non-emergenc y infrarenal aortic surgery throughout the British Isles, and to determine the influence of risk factors on mortality rate. Methods: This was a multicentre, prospective audit of 177 hospitals through out the UK and Ireland. Data were collected by questionnaire to include ail patients undergoing elective or urgent surgery for infrarenal abdominal ao rtic aneurysm or aortoiliac occlusive disease over 4 months. Results: Nine hundred and thirty-three patients were recruited into the aud it. The overall mortality rate was 7.3 per cent. Factors increasing the ris k of death by up to fivefold included age over 74 years, urgent surgery, op eration for occlusive disease, limited exercise capacity, a history of seve re angina or cardiac failure, the presence of ventricular ectopics and abno rmalities suggesting ischaemic heart disease on electrocardiography. Conclusion: Although the in-hospital mortality rate was similar to previous ly published figures, the rate increased considerably when commonly encount ered risk factors were present.