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Outcome of treatment of ruptured abdominal aortic aneurysms depending on the type of hospital.

Zdanowski, Z; Danielsson, Gudmundur LU ; Jonung, T; Kaij, J; Ribbe, Else LU ; Sahlin, Ch; Schatz, Patrik LU ; Thörne, Johan LU and Norgren, Lars LU (2002) In European Journal of Surgery 168(2). p.96-100
Abstract
OBJECTIVE: To compare the outcome of patients operated on acutely for ruptured abdominal aortic aneurysms (AAA) or otherwise symptomatic aortic aneurysms in a university hospital and in two county hospitals by the same group of vascular surgeons. DESIGN: Retrospective study. SETTING: 1 university and 2 county hospitals, Sweden. SUBJECTS: 108 patients operated on urgently for AAA, 81 at the university hospital, and 27 at the county hospitals between January 1992 and December 1998. INTERVENTION: Repair of the AAA. MAIN OUTCOME MEASURES: Morbidity and mortality. RESULTS: 21 of the 81 patients having urgent repair of an AAA at the university hospital (26%) had been transferred from the county hospitals. Thirteen patients were not operated on,... (More)
OBJECTIVE: To compare the outcome of patients operated on acutely for ruptured abdominal aortic aneurysms (AAA) or otherwise symptomatic aortic aneurysms in a university hospital and in two county hospitals by the same group of vascular surgeons. DESIGN: Retrospective study. SETTING: 1 university and 2 county hospitals, Sweden. SUBJECTS: 108 patients operated on urgently for AAA, 81 at the university hospital, and 27 at the county hospitals between January 1992 and December 1998. INTERVENTION: Repair of the AAA. MAIN OUTCOME MEASURES: Morbidity and mortality. RESULTS: 21 of the 81 patients having urgent repair of an AAA at the university hospital (26%) had been transferred from the county hospitals. Thirteen patients were not operated on, 7 because of their poor general condition and great age (median 84 years), 3 who refused operation, and 3 in whom the diagnosis was incorrect. During the same time period a further 27 haemodynamically unstable patients were operated on by the same vascular surgeons at the county hospitals. The on-table mortality for patients with ruptured AAA and shock was 5/43 (12%) at the university hospital and 4/27 (15%) at the county hospitals. The corresponding in-hospital rates were 11/43 (26%) and 11/27 (41%). Mortality was significantly higher if the operation was delayed by more than 45 minutes. The incidence of postoperative complications was the same in both hospitals. CONCLUSION: If a patient with a ruptured AAA and shock is admitted to the county hospital and operated on by a specialist vascular surgeon the outcome is fully acceptable. The difference seems to be related to the postoperative period. To what extent the delay caused by the surgeon's journey to the county hospital has any influence on the outcome is not possible to evaluate. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Journal of Surgery
volume
168
issue
2
pages
96 - 100
publisher
Taylor & Francis
external identifiers
  • pmid:12113278
  • wos:000175415500006
  • scopus:0036255434
ISSN
1102-4151
DOI
10.1080/11024150252884313
language
English
LU publication?
yes
id
aea98d6d-aae9-446d-8d63-513cda4b5f90 (old id 109302)
alternative location
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=12113278&dopt=Abstract
date added to LUP
2007-07-20 13:39:17
date last changed
2017-01-01 06:49:19
@article{aea98d6d-aae9-446d-8d63-513cda4b5f90,
  abstract     = {OBJECTIVE: To compare the outcome of patients operated on acutely for ruptured abdominal aortic aneurysms (AAA) or otherwise symptomatic aortic aneurysms in a university hospital and in two county hospitals by the same group of vascular surgeons. DESIGN: Retrospective study. SETTING: 1 university and 2 county hospitals, Sweden. SUBJECTS: 108 patients operated on urgently for AAA, 81 at the university hospital, and 27 at the county hospitals between January 1992 and December 1998. INTERVENTION: Repair of the AAA. MAIN OUTCOME MEASURES: Morbidity and mortality. RESULTS: 21 of the 81 patients having urgent repair of an AAA at the university hospital (26%) had been transferred from the county hospitals. Thirteen patients were not operated on, 7 because of their poor general condition and great age (median 84 years), 3 who refused operation, and 3 in whom the diagnosis was incorrect. During the same time period a further 27 haemodynamically unstable patients were operated on by the same vascular surgeons at the county hospitals. The on-table mortality for patients with ruptured AAA and shock was 5/43 (12%) at the university hospital and 4/27 (15%) at the county hospitals. The corresponding in-hospital rates were 11/43 (26%) and 11/27 (41%). Mortality was significantly higher if the operation was delayed by more than 45 minutes. The incidence of postoperative complications was the same in both hospitals. CONCLUSION: If a patient with a ruptured AAA and shock is admitted to the county hospital and operated on by a specialist vascular surgeon the outcome is fully acceptable. The difference seems to be related to the postoperative period. To what extent the delay caused by the surgeon's journey to the county hospital has any influence on the outcome is not possible to evaluate.},
  author       = {Zdanowski, Z and Danielsson, Gudmundur and Jonung, T and Kaij, J and Ribbe, Else and Sahlin, Ch and Schatz, Patrik and Thörne, Johan and Norgren, Lars},
  issn         = {1102-4151},
  language     = {eng},
  number       = {2},
  pages        = {96--100},
  publisher    = {Taylor & Francis},
  series       = {European Journal of Surgery},
  title        = {Outcome of treatment of ruptured abdominal aortic aneurysms depending on the type of hospital.},
  url          = {http://dx.doi.org/10.1080/11024150252884313},
  volume       = {168},
  year         = {2002},
}