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Improved In-Hospital Outcomes for a Ruptured Abdominal Aortic Aneurysm Over Time: A Single-Center Retrospective
Koki Yokawa1, Taku Nakagawa1, Makoto Kusakizako1
1Department of Cardiovascular Surgery, Kakogawa Central City Hospital, Kakogawa, JPN.
Cureus
|February 23, 2026
Summary
Rapid surgical intervention for ruptured abdominal aortic aneurysms (rAAA) significantly improves patient outcomes. Shorter operative delays in open surgical repair (OS) correlate with reduced mortality rates and better long-term survival.
Area of Science:
- Vascular Surgery
- Surgical Outcomes Research
- Aortic Aneurysm Management
Background:
- Open surgical repair (OS) is the standard treatment for ruptured abdominal aortic aneurysms (rAAA).
- Evaluating treatment outcomes and temporal management changes is crucial for improving patient survival.
Purpose of the Study:
- To assess in-hospital and long-term outcomes of rAAA treatment in a community hospital.
- To analyze the impact of operative delay on patient survival and management strategies.
Main Methods:
- Retrospective analysis of 58 patients undergoing emergency surgery for rAAA (Nov 2012 - Mar 2025).
- Primary treatment was OS (51 cases); endovascular aneurysm repair (EVAR) was selectively used (7 cases).
- Comparison of outcomes between early and late treatment groups based on time to surgery.
Main Results:
- In-hospital mortality was 22.4% (13/58), exclusively in the OS group.
- Mortality decreased from 37.9% to 6.9% with shorter time to surgery (median 109 vs. 217 minutes).
- Five-year survival rate was 58% ± 7%.
Conclusions:
- Shorter time to surgery is a key factor in improving outcomes for rAAA patients.
- Rapid surgical intervention, even with OS as the primary strategy, leads to favorable results.
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