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Abdominal aortic aneurysms--a national multicentre study.

S Amundsen1, A Trippestad, A Viste

  • 1Department of Surgery, University of Bergen, Norway.

European Journal of Vascular Surgery
|August 1, 1987
PubMed
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Decentralizing vascular services for abdominal aortic aneurysms may not improve outcomes. This study found higher mortality in patients with ruptured or impending rupture aneurysms treated non-centrally compared to specialized centers.

Area of Science:

  • Vascular Surgery
  • Health Services Research

Background:

  • Abdominal aortic aneurysms (AAA) require specialized vascular services.
  • The diffusion of vascular services aims to broaden access but may impact treatment quality.

Purpose of the Study:

  • To investigate the impact of vascular service diffusion on treatment outcomes for abdominal aortic aneurysms.
  • To compare results between elective surgery and acute rupture cases.

Main Methods:

  • Prospective, observational, multicentre study.
  • 444 consecutive patients with abdominal aortic aneurysms.
  • Categorization into elective surgery (E), ruptured (R), and impending rupture (IR) groups.

Main Results:

  • Patients with acute symptoms (R+IR) were older with larger aneurysms than the E group.

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  • Postoperative mortality rates: 7.5% (E), 16.7% (IR), 63.1% (R).
  • Treatment results for high-risk patients were inferior to those from specialized institutions.

    • Conclusions:

    • The diffusion of vascular surgical services may not have benefited patients with complex AAA.
    • Outcomes suggest that centralized expertise remains crucial for high-risk aneurysm cases.
    • Further analysis is needed to fully understand the implications of service diffusion.