[Must all ruptured aneurysms of the aorta be operated on?]

Surgery is the only means of saving the life of patients with ruptured aneurysm of aorta, but it is universally accepted that the chance of survival is very low in case of prolonged collapse in patients over 80 years. Definition of pre-operative factors of severity and analysis of their effect on postoperative mortality showed that neither advanced age nor collapse nor anuria on admission allowed exclusion of patients when evaluated singly. When associated, however, the mortality rate becomes very high, but in this case any result of less than 100% mortality implies progress and should incite operation. In contrast, when patients with aneurysms have been excluded on other grounds then the contraindication to surgery should be maintained in case of rupture.