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Abdominal aortic aneurysm in south-west Scotland
R N Meddings1, J S McCormick, G C Mannam
1Department of Surgery, Dumfries and Galloway Royal Infirmary, UK.
Journal of the Royal College of Surgeons of Edinburgh
|February 1, 1991
Summary
Prompt diagnosis and transfer to specialized centers significantly improve survival rates for patients with leaking abdominal aortic aneurysms. Early detection is crucial, as delays in diagnosis, often mistaken for renal colic, increase mortality risks.
Area of Science:
- Vascular Surgery
- Aortic Aneurysm Research
- Healthcare Management
Background:
- Abdominal aortic aneurysms (AAAs) pose a significant surgical challenge.
- Mortality rates for ruptured AAAs vary based on treatment location and expertise.
- Timely diagnosis and appropriate management are critical for patient outcomes.
Purpose of the Study:
- To analyze the outcomes of abdominal aortic aneurysm treatment in a regional health setting.
- To evaluate the impact of local treatment versus transfer to a major vascular center for ruptured AAAs.
- To identify factors contributing to mortality in AAA cases, particularly concerning diagnosis and surgical expertise.
Main Methods:
- Retrospective tracing of 155 patients with abdominal aortic aneurysms (1977-1988).
- Analysis of surgical outcomes (elective vs. ruptured, local vs. transferred, surgeon expertise).
- Review of diagnostic timelines and errors for non-surgically treated ruptured AAA patients.
Main Results:
- Elective AAA repair locally had zero mortality.
- Ruptured AAA patients transferred to a vascular center had a 36% mortality rate.
- Local treatment of ruptured AAAs by surgeons without vascular interest had a 66% mortality rate.
- Delayed diagnosis (over 3 hours) in non-surgically treated ruptured AAA patients was common, with renal colic being a frequent misdiagnosis.
Conclusions:
- Patients with leaking abdominal aortic aneurysms benefit from transfer to major vascular units lacking local expertise.
- Transfer does not appear to negatively impact survival rates for ruptured AAA.
- Prompt and accurate diagnosis at the hospital level is essential to reduce mortality, highlighting the need for improved diagnostic protocols and awareness of AAA symptoms.