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A Multidisciplinary Protocolized Approach for Ruptured Abdominal Aortic Aneurysm Management: A Retrospective
Rayaan A Yunus1, Shirin Saeed1, Nadav Levy1
1Department of Anesthesia, Critical Care & Pain Medicine Department, Beth Israel Deaconess Medical Center, Boston, MA.
Journal of Cardiothoracic and Vascular Anesthesia
|January 14, 2024
Summary
A new multidisciplinary protocol for ruptured abdominal aortic aneurysm (rAAA) management significantly reduced in-hospital mortality and adverse complications for both endovascular and open repairs. This standardized approach improved patient outcomes and quality of care.
Area of Science:
- Vascular Surgery
- Surgical Protocols
- Aortic Aneurysm Management
Background:
- Ruptured abdominal aortic aneurysms (rAAA) are associated with high mortality rates.
- Standardized management protocols are crucial for improving outcomes in critical surgical conditions.
Purpose of the Study:
- To evaluate the impact of a multidisciplinary protocol on adverse complication rates in patients with ruptured abdominal aortic aneurysms (rAAA).
Main Methods:
- Retrospective before-and-after study comparing patients before (2015-2018) and after (2019-2022) protocol implementation.
- Protocol involved standardized workflow for vascular surgery, anesthesia, ED, and OR staff.
- Data analyzed for in-hospital mortality, all-cause morbidity, and specific complications.
Main Results:
- Protocol implementation led to significantly shorter times to incision and total procedure time.
- Reduced in-hospital mortality for endovascular repair (46.2% vs. 20.0%) and open repair (53.3% vs. 27.3%).
- Lower rates of all-cause morbidity and renal complications for endovascular repair, and bowel ischemia for open repair were observed post-protocol.
Conclusions:
- A multidisciplinary rAAA management protocol can decrease adverse complications.
- Implementation of such protocols enhances the quality of care for rAAA patients.
