Rupture of abdominal aortic aneurysm--factors of mortality

The purpose of this study was to evaluate the main factors of the 30-day mortality rate in patients operated on for rupture of abdominal aortic aneurysm (RAAA).

Univariate and multivariate analysis of various factors associated with RAAA was performed in the group of 182 patients operated on for RAAA between 1/1/1992 to 1/9/2005.

The 30-day mortality rate was 33.5%. The main mortality factors were: misdiagnosis, cardiopulmocerebral resuscitation (CPCR) on admission, configuration of RAAA(p<0.001), number of blood transfusions, hypotension on admission (p<0.0001) and duration of operation, type of reconstruction and hypertension in history (p<0.01). Important factors (p<0.05) of postoperative mortality included also low haemoglobin level on admission, abdominal aortic aneurysm (AAA) diameter and ischaemic heart disease in history. The probability of patient's death is the highest (p<0.003), if factors like CPCR, number of blood transfusions and aneurysm diameter are combined (multivariate analysis, stepwise method).

The early detection and surgical or endovascular elective treatment of AAA, regular dispensarization of patients with small AAA, especially hypertonics, correct diagnosis of RAAA without time delay, are the best tools for patients survival. The patient's survival increases with trained prehospital resuscitation system and experienced team of vascular surgeons and anestesiologists in centres (Tab. 3, Ref. 20).