[The ruputured abdominal aortic aneurysm--a multifactorial study]

We examined the outcome of patients with ruptured abdominal aortic aneurysm and analysed factors that were responsible for the mortality.

From January 1 (st), 1999 to March 1 (st), 2005 82 patients with ruptured abdominal aortic aneurysm were registered in the University Hospital of Pilsen. 61 men, 21 women entered the hospital, the average age of the patients ranged to 73.5+/-6.8 years. The average time interval between first symptoms and admission to the hospital ranged to 23.9 hours. In 74 patients (90,3%) a reconstruction of the vascular system was performed, in 8 patients the reconstruction was no more possible, these patients died in the operating theatre.

The peri- and postoperative mortality (30-day-mortality) ranged to 37.8% (31 of 82 patients). The patients were on average for 2.3+/-4 days artificially ventilated postoperatively, the mean time of hospital stay ranged to 14.5+/-16,7 days. Respiratory failure, multiple organ failure, the necessity of cardiocirculatory resuscitation, patient age and ischemic heart disease, and the hemoglobin value on admission correlated significantly with the mortality.

The present study demonstrates that the severe situation of ruptured abdominal aortic aneurysm is not without a chance, many patients can be successfully managed. The success of treatment depends partly on factors which cannot be influenced by the surgeon, but other factors (for example hemoperitoneum und decreasing hemoglobin level) can be managed by quick diagnostics and expensive postoperative intensive care.