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Factors determining survival after ruptured aortic aneurysm: the hospital, the surgeon, and the patient.

Abstract：

:The 10-year experience of a single community was reviewed and a multivariate analysis was performed to determine the relative importance of clinical and environmental factors in mortality after ruptured abdominal aortic aneurysm resection. Ruptured aneurysms were repaired in 243 patients in six area hospitals (one university, five community) by 25 surgeons (16 vascular, 9 general). Overall, 30-day mortality was 55% (133/243). Although the mortality by hospital ranged from 44% to 68%, these differences were not statistically significant. However, significant variations occurred in the mortality rates of individual surgeons, ranging from 44% to 73%. The mortality rate for the vascular surgeons was less than that of the general surgeons, 51% versus 69% (p less than 0.05). Clinical factors were evaluated, and the most significant parameters were systolic blood pressure, presence of chronic obstructive lung disease, and history of chronic renal insufficiency. These results support the implication that the degree of specialization of the surgeon and the preexisting health of the patient are the most important determinants of survival after ruptured abdominal aortic aneurysm. The size and sophistication of the hospital appear to be less influential factors.

journal_name

J Vasc Surg

journal_title

Journal of vascular surgery

authors

Ouriel K,Geary K,Green RM,Fiore W,Geary JE,DeWeese JA

doi

10.1067/mva.1990.18639

subject

Has Abstract

pub_date

1990-04-01 00:00:00

pages

493-6

issue

4

eissn

0741-5214

issn

1097-6809

pii

0741-5214(90)90292-I

journal_volume

11

pub_type

杂志文章

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