The ruptured abdominal aortic aneurysm in a community hospital. A 5-year study

The authors report on a recent 5-year experience with the treatment of ruptured abdominal aortic aneurysms in a community hospital located in a frequently visited tourist center. Their mortality rate of 43 per cent compares favorably with accepted mortality rates from large teaching institutions. Several known complications of this condition occurred in the authors' series. The most ominous complications that carried the highest associated mortality rates, if the patient did not succumb in the operating room, were acute tubular necrosis (75% associated mortality) and bowel infarction (100% associated mortality). Most important, physicians must have a high index of suspicion to make the diagnosis early. As reported in other series, prolonged hypotension and blood loss has a direct correlation with high mortality.