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A Statewide Experience

J. David Richardson, MD; Karen A. Main, PhD

Arch Surg. 1991;126(5):614-616.

Abstract
• The results of elective treatment of abdominal aortic aneurysmsare excellent in many institutions. To our knowledge, however, no study has compared the results in a large geographic area in which patients were treated by a variety of surgeons and hospitals. We studied the results of repairing abdominal aortic aneurysms for all Medicare recipients during a single year in Kentucky. One hundred thirty-six operations were performed by 52 surgeons in 31 hospitals. Overall operative mortality was 18%; elective and emergency operative mortality rates were 6% and 49%, respectively. Advancing age did not affect outcome, but mortality due to ruptured aneurysms was higher in smaller hospitals than in larger hospitals. The low mortality for elective repair of abdominal aortic aneurysms in an elderly population by numerous surgeons in divergent hospitals is a strong indication for its liberal use compared with the high mortality and morbidity of emergency surgery.

(Arch Surg. 1991;126:614-616)

Author Affiliations
From the Department of Surgery, Division of General Surgery, University of Louisville (Ky) School of Medicine (Dr Richardson), and the Kentucky Legislative Research Commission, Frankfort (Dr Main). Dr Main provided the statistical analysis.

Footnotes
Accepted for publication October 6, 1990.

Read before the annual meeting of the Southern Association for Vascular Surgery, Acapulco, Mexico, January 25, 1990.

Reprint requests to the Department of Surgery, University of Louisville, Louisville, KY 40292 (Dr Richardson).

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