Ruptured thoracoabdominal aortic aneurysm treatment in the United States: 1988 to 1998

Thoracoabdominal aortic aneurysm (TAAA) rupture usually results in death. The outcome remains poor for patients who reach the operating room. The objective of this investigation was to define contemporary surgical experience with ruptured TAAA in the United States. Clinical data derived from the Nat...

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Veröffentlicht in:Journal of vascular surgery 2003-08, Vol.38 (2), p.319-322
Hauptverfasser: Cowan, John A, Dimick, Justin B, Wainess, Reid M, Henke, Peter K, Stanley, James C, Upchurch, Gilbert R
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container_issue 2
container_start_page 319
container_title Journal of vascular surgery
container_volume 38
creator Cowan, John A
Dimick, Justin B
Wainess, Reid M
Henke, Peter K
Stanley, James C
Upchurch, Gilbert R
description Thoracoabdominal aortic aneurysm (TAAA) rupture usually results in death. The outcome remains poor for patients who reach the operating room. The objective of this investigation was to define contemporary surgical experience with ruptured TAAA in the United States. Clinical data derived from the Nationwide Inpatient Sample on patients who underwent repair of a ruptured TAAA from 1988 to 1998 were analyzed. Age, sex, race, nature of admission, comorbid conditions, and provider volume were abstracted from the database. In-hospital mortality, postoperative complications, and length of stay were the principal outcome measures. Three hundred twenty-one patients were identified for the study. Mean age was 71.5 years; men outnumbered women (63% vs 37%). Crude overall surgical mortality was 53.8% and did not improve over time. Operative mortality was most likely (51%) to occur within the first 24 hours postoperatively. Median length of stay for surviving patients was 16 days. Renal failure (28%) and cardiac complications (18%) were the most common complications. In a logistic regression model, age greater than 77 years was predictive of death (odds ratio [OR], 2.5; P = .005), and nonwhite race appeared protective (OR, 0.53; P = .013). Mortality after surgical treatment of ruptured TAAA is high. Surviving patients experience many postoperative complications and have lengthy hospital stays. Given the lack of significant improvement in contemporary surgical practice, new techniques of repair deserve the attention of clinicians.
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Graft diseases</topic><topic>Surgery of the heart</topic><topic>Treatment Outcome</topic><topic>United States - epidemiology</topic><topic>Vascular Surgical Procedures - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cowan, John A</creatorcontrib><creatorcontrib>Dimick, Justin B</creatorcontrib><creatorcontrib>Wainess, Reid M</creatorcontrib><creatorcontrib>Henke, Peter K</creatorcontrib><creatorcontrib>Stanley, James C</creatorcontrib><creatorcontrib>Upchurch, Gilbert R</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cowan, John A</au><au>Dimick, Justin B</au><au>Wainess, Reid M</au><au>Henke, Peter K</au><au>Stanley, James C</au><au>Upchurch, Gilbert R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ruptured thoracoabdominal aortic aneurysm treatment in the United States: 1988 to 1998</atitle><jtitle>Journal of vascular surgery</jtitle><addtitle>J Vasc Surg</addtitle><date>2003-08-01</date><risdate>2003</risdate><volume>38</volume><issue>2</issue><spage>319</spage><epage>322</epage><pages>319-322</pages><issn>0741-5214</issn><eissn>1097-6809</eissn><coden>JVSUES</coden><abstract>Thoracoabdominal aortic aneurysm (TAAA) rupture usually results in death. 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subjects Adult
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - mortality
Aortic Aneurysm, Abdominal - surgery
Aortic Aneurysm, Thoracic - mortality
Aortic Aneurysm, Thoracic - surgery
Aortic Rupture - mortality
Aortic Rupture - surgery
Biological and medical sciences
Female
Humans
Male
Medical sciences
Middle Aged
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Treatment Outcome
United States - epidemiology
Vascular Surgical Procedures - methods
title Ruptured thoracoabdominal aortic aneurysm treatment in the United States: 1988 to 1998
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