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A Journal on Vascular and Endovascular Surgery
Giornale Italiano di Chirurgia Vascolare 2003 September;10(3):281-90
language: English, Italian
Abdominal aortic aneurysms. What is their correct management? Personal experience
Mastromarino A., Ventura M., Rivellini C., Saracino G., Spartera C.
Cattedra e Scuola di Specializzazione in Chirurgia Vascolare Università degli Studi di L’Aquila, L’Aquila
Aim. The operative mortality rate for ruptured abdominal aortic aneurysms is still too high. In our experience, we tried to identify the statistically significant variables that act as predictors of death, and when present, we used these to modify our therapeutic approach.
Methods. We carried out a retrospective study of the last 200 abdominal aortic aneurysms. Thirty-one patients (15.5%) underwent emergency surgery following rupture with shock. The operative mortality rate was 78%. A computerised analysis was made of the frequency of variables found to be significant, based on the data reported in the literature, as predictors of death. These included: age, hypovolemic shock, cardiac arrest, low hematocrit value, loss of consciousness.
Results. Although this sample was not statistically relevant, the variables identified were found in almost 100% of patients who died in the operating theatre or in the immediate postoperative period (mean 30 hours). On the contrary, these variables were only observed in 30% of the surviving patients.
Conclusion. On the basis of the data reported in the literature and our experience, we can affirm that the decision not to operate should be taken into consideration in patients presenting all the statistically significant variables.