Ruptured Abdominal Aortic Aneurysms: A Retrospective Look at a Ten-Year Interval

Abstract

Ruptured abdominal aortic aneurysms (AAAs) remain a lethal entity despite early recognition, prompt intervention, and technological advances in critical care. Elective resection of AAAs offers the best survival. Two distinct experi ences, 1977 to 1980 (Group I) and 1989 to 1990 (Group II), were retrospectively reviewed. Major postoperative complications were renal and respiratory failure in both time periods. Acute renal failure was seen in 38% of patients in both groups. Respiratory failure was seen in 29% of patients in Group I and 48% of patients in Group II. Overall mortality was 44% in Group I and 48% in Group II. Hemodynamic instability upon presentation continues to be an ominous prognostic indicator (54% mortality in Group I and 80% mortality in Group II). Morbidity and mortality for surgery for ruptured AAA remain very high and largely unchanged over the years. If no contraindication to surgery exists, the authors recommend elective resection of AAA at diagnosis.

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