Repair of abdominal aortic aneurysms. A statewide experience
J. D. Richardson and K. A. Main
Department of Surgery, University of Louisville School of Medicine, KY 40292.
The results of elective treatment of abdominal aortic aneurysms are
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.