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Ruptured infrarenal aortic aneurysm--a critical evaluation
T Bürger1, F Meyer, J Tautenhahn
1Klinik für Chirurgie, Otto-von-Guericke Universität Magdeburg, Germany.
VASA. Zeitschrift Fur Gefasskrankheiten
|April 7, 1999
Summary
Emergency management of ruptured infrarenal aortic aneurysms is critical. The APACHE II score effectively predicts patient prognosis and aids in comparing treatment outcomes for ruptured aortic aneurysms.
Area of Science:
- Vascular Surgery
- Emergency Medicine
- Critical Care
Background:
- Ruptured infrarenal aortic aneurysms present rare emergency management challenges.
- Objective evaluations of these emergency situations are infrequently documented.
Purpose of the Study:
- To retrospectively evaluate the management and outcomes of patients with ruptured infrarenal aortic aneurysms.
- To assess the utility of the APACHE II score in predicting prognosis for these critically ill patients.
Main Methods:
- Retrospective analysis of 52 consecutive patients with ruptured infrarenal aortic aneurysms admitted between 1993 and 1998.
- Review of emergency protocols, final reports, and follow-up data.
- Assessment of APACHE II scores at admission and on the fifth postoperative day.
Main Results:
- A significant delay in hospital referral (>5 hours) was observed in 71% of patients.
- 71% of patients presented with signs of shock; 81% underwent ultrasound as the initial diagnostic tool.
- The overall mortality rate was 36.5%, with higher mortality associated with elevated APACHE II scores (e.g., no survivors with >75% predicted death probability on day 5).
Conclusions:
- Surgical intervention is essential for ruptured aortic aneurysms.
- Preclinical and anesthetic management significantly influence clinical outcomes.
- The APACHE II score is a valuable tool for approximating disease severity and patient prognosis, enabling comparison of treatment results across diverse patient groups.