Factors Affecting Mortality Rate of Ruptured Abdominal Aortic Aneurysm

ABSTRACT

PURPOSE: Ruptured abdominal aortic aneurysm (RAAA) still carries high operative mortality, despite improvements in anesthesia, intensive perioperative monitoring, surgical methods. The authors reported on the factors affecting mortality rate of the RAAA providing clues for successful operations. METHODS: Charts of the patients, who received operations for RAAAs at Asan Medical Center from July 1990 to July 1998 were reviewed to find out whether there is a difference between survival group and fatal group. RESULTS: Multivariate statistical analysis of factors between survival group (12 patients) and fatal group (7 patients) showed that preoperative loss of consciousness, cardiopulmonary resuscitation, and intraperitoneal free rupture were the factors affecting poor prognosis. Improvement in survival was also noted in patients who were treated in latter period (since January 1997) when autotransfusion using the cell saver and circulatory monitoring with Swan-Ganz cathter were introduced. Other risk factors were similar between the earlier group (8 patients) and latter group (11 patients). CONCLUSION: Rapid and accurate diagnosis of RAAA and timely transfer to the operating room for laparotomy is cleary paramount, and this can decrease the mortality of RAAA.