An "all comers" policy for ruptured abdominal aortic aneurysms: how can results be improved?
Objective: To review our experience of a non‐selective policy for the treatment of ruptured abdominal aortic aneurysm to see if the policy was justified, and to identify any preoperative risk factors that adversely influenced outcome. Design: Retrospective study. Setting: Teaching hospital, Republic...
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| Veröffentlicht in: | The European journal of surgery 1998-04, Vol.164 (4), p.263-270 |
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| container_title | The European journal of surgery |
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| creator | Barry, Mary C. Burke, Paul E. Sheehan, Stephen Leahy, Austin Broe, Patrick J. Bouchier-Hayes, David J. |
| description | Objective:
To review our experience of a non‐selective policy for the treatment of ruptured abdominal aortic aneurysm to see if the policy was justified, and to identify any preoperative risk factors that adversely influenced outcome.
Design:
Retrospective study.
Setting:
Teaching hospital, Republic of Ireland.
Subjects:
258 patients admitted with abdominal aortic aneurysms between January 1982 and December 1993.
Interventions:
Definitive surgical treatment.
Main outcome measures:
Morbidity, mortality, and risk factors.
Results:
In‐hospital mortality for all patients was 43% (110/258). Overall, women did worse than men (28/44, 64%, died, compared with 96/214, 45%, p = 0.03). The mortality among patients over the age of 80 (23/45, 51%) was not significantly different from that among younger patients (97/202, 48%). Blood pressure, platelet count, and haemoglobin concentration were all significantly lower preoperatively among those who died (p < 0.05).
Conclusions:
Age alone cannot be used to justify witholding definitive surgical treatment. Treatment should be aimed towards reversing haematological and haemodynamic abnormalities preoperatively to try to improve outcome. Copyright © 1998 Taylor and Francis Ltd. |
| doi_str_mv | 10.1080/110241598750004481 |
| format | Article |
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To review our experience of a non‐selective policy for the treatment of ruptured abdominal aortic aneurysm to see if the policy was justified, and to identify any preoperative risk factors that adversely influenced outcome.
Design:
Retrospective study.
Setting:
Teaching hospital, Republic of Ireland.
Subjects:
258 patients admitted with abdominal aortic aneurysms between January 1982 and December 1993.
Interventions:
Definitive surgical treatment.
Main outcome measures:
Morbidity, mortality, and risk factors.
Results:
In‐hospital mortality for all patients was 43% (110/258). Overall, women did worse than men (28/44, 64%, died, compared with 96/214, 45%, p = 0.03). The mortality among patients over the age of 80 (23/45, 51%) was not significantly different from that among younger patients (97/202, 48%). Blood pressure, platelet count, and haemoglobin concentration were all significantly lower preoperatively among those who died (p < 0.05).
Conclusions:
Age alone cannot be used to justify witholding definitive surgical treatment. Treatment should be aimed towards reversing haematological and haemodynamic abnormalities preoperatively to try to improve outcome. Copyright © 1998 Taylor and Francis Ltd.</description><identifier>ISSN: 1102-4151</identifier><identifier>EISSN: 1741-9271</identifier><identifier>DOI: 10.1080/110241598750004481</identifier><identifier>PMID: 9641367</identifier><language>eng</language><publisher>UK: Taylor & Francis, Ltd</publisher><subject>Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal - mortality ; Aortic Aneurysm, Abdominal - surgery ; Aortic Rupture - mortality ; Aortic Rupture - surgery ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Diseases of the aorta ; Female ; Hospital Mortality ; Humans ; Male ; Medical sciences ; Middle Aged ; Patient Selection ; Retrospective Studies ; Risk Factors ; Treatment Outcome</subject><ispartof>The European journal of surgery, 1998-04, Vol.164 (4), p.263-270</ispartof><rights>Copyright © 1998 Taylor and Francis Ltd</rights><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4567-d69e4ed77718265f91a581d709a386cfab80181816ea2f65b3971b2c57bca2b43</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2230093$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9641367$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Barry, Mary C.</creatorcontrib><creatorcontrib>Burke, Paul E.</creatorcontrib><creatorcontrib>Sheehan, Stephen</creatorcontrib><creatorcontrib>Leahy, Austin</creatorcontrib><creatorcontrib>Broe, Patrick J.</creatorcontrib><creatorcontrib>Bouchier-Hayes, David J.</creatorcontrib><title>An "all comers" policy for ruptured abdominal aortic aneurysms: how can results be improved?</title><title>The European journal of surgery</title><addtitle>Eur J Surg</addtitle><description>Objective:
To review our experience of a non‐selective policy for the treatment of ruptured abdominal aortic aneurysm to see if the policy was justified, and to identify any preoperative risk factors that adversely influenced outcome.
Design:
Retrospective study.
Setting:
Teaching hospital, Republic of Ireland.
Subjects:
258 patients admitted with abdominal aortic aneurysms between January 1982 and December 1993.
Interventions:
Definitive surgical treatment.
Main outcome measures:
Morbidity, mortality, and risk factors.
Results:
In‐hospital mortality for all patients was 43% (110/258). Overall, women did worse than men (28/44, 64%, died, compared with 96/214, 45%, p = 0.03). The mortality among patients over the age of 80 (23/45, 51%) was not significantly different from that among younger patients (97/202, 48%). Blood pressure, platelet count, and haemoglobin concentration were all significantly lower preoperatively among those who died (p < 0.05).
Conclusions:
Age alone cannot be used to justify witholding definitive surgical treatment. Treatment should be aimed towards reversing haematological and haemodynamic abnormalities preoperatively to try to improve outcome. Copyright © 1998 Taylor and Francis Ltd.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aortic Aneurysm, Abdominal - mortality</subject><subject>Aortic Aneurysm, Abdominal - surgery</subject><subject>Aortic Rupture - mortality</subject><subject>Aortic Rupture - surgery</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Diseases of the aorta</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Patient Selection</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><issn>1102-4151</issn><issn>1741-9271</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkFFrFDEUhYMotVb_gCCEIr6N5mYyycQXqUutlqIFlX0Rwp1MBqOZyZrMtN1_b3SXffFF7kMunO-cGw4hT4G9BNayVwCMC2h0qxrGmBAt3CPHoARUmiu4X_YCVIWAh-RRzj8KBLXiR-RISwG1VMfk29lETzEEauPoUj6lmxi83dIhJpqWzbwk11Ps-jj6CQPFmGZvKU5uSds85tf0e7ylFieaXF7CnGnnqB83Kd64_s1j8mDAkN2T_XtCvr47_7J6X119uviwOruqrGikqnqpnXC9UgpaLptBAzYt9IpprFtpB-xaBm0Z6ZAPsulqraDjtlGdRd6J-oS82OWWu78Wl2cz-mxdCOWfcclGaS1BAC8g34E2xZyTG8wm-RHT1gAzfyo1_1ZaTM_26Us3uv5g2XdY9Od7HbPFMCScrM8HjPOaMV0XTO6wWx_c9j8Om_PLz_pvfrUz-jy7u4MR009TVNWY9ccLc81Xl-v19VvD69-DUJtF</recordid><startdate>199804</startdate><enddate>199804</enddate><creator>Barry, Mary C.</creator><creator>Burke, Paul E.</creator><creator>Sheehan, Stephen</creator><creator>Leahy, Austin</creator><creator>Broe, Patrick J.</creator><creator>Bouchier-Hayes, David J.</creator><general>Taylor & Francis, Ltd</general><general>Taylor & Francis</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199804</creationdate><title>An "all comers" policy for ruptured abdominal aortic aneurysms: how can results be improved?</title><author>Barry, Mary C. ; Burke, Paul E. ; Sheehan, Stephen ; Leahy, Austin ; Broe, Patrick J. ; Bouchier-Hayes, David J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4567-d69e4ed77718265f91a581d709a386cfab80181816ea2f65b3971b2c57bca2b43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aortic Aneurysm, Abdominal - mortality</topic><topic>Aortic Aneurysm, Abdominal - surgery</topic><topic>Aortic Rupture - mortality</topic><topic>Aortic Rupture - surgery</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Diseases of the aorta</topic><topic>Female</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Patient Selection</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Barry, Mary C.</creatorcontrib><creatorcontrib>Burke, Paul E.</creatorcontrib><creatorcontrib>Sheehan, Stephen</creatorcontrib><creatorcontrib>Leahy, Austin</creatorcontrib><creatorcontrib>Broe, Patrick J.</creatorcontrib><creatorcontrib>Bouchier-Hayes, David J.</creatorcontrib><collection>Istex</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>The European journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Barry, Mary C.</au><au>Burke, Paul E.</au><au>Sheehan, Stephen</au><au>Leahy, Austin</au><au>Broe, Patrick J.</au><au>Bouchier-Hayes, David J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An "all comers" policy for ruptured abdominal aortic aneurysms: how can results be improved?</atitle><jtitle>The European journal of surgery</jtitle><addtitle>Eur J Surg</addtitle><date>1998-04</date><risdate>1998</risdate><volume>164</volume><issue>4</issue><spage>263</spage><epage>270</epage><pages>263-270</pages><issn>1102-4151</issn><eissn>1741-9271</eissn><abstract>Objective:
To review our experience of a non‐selective policy for the treatment of ruptured abdominal aortic aneurysm to see if the policy was justified, and to identify any preoperative risk factors that adversely influenced outcome.
Design:
Retrospective study.
Setting:
Teaching hospital, Republic of Ireland.
Subjects:
258 patients admitted with abdominal aortic aneurysms between January 1982 and December 1993.
Interventions:
Definitive surgical treatment.
Main outcome measures:
Morbidity, mortality, and risk factors.
Results:
In‐hospital mortality for all patients was 43% (110/258). Overall, women did worse than men (28/44, 64%, died, compared with 96/214, 45%, p = 0.03). The mortality among patients over the age of 80 (23/45, 51%) was not significantly different from that among younger patients (97/202, 48%). Blood pressure, platelet count, and haemoglobin concentration were all significantly lower preoperatively among those who died (p < 0.05).
Conclusions:
Age alone cannot be used to justify witholding definitive surgical treatment. Treatment should be aimed towards reversing haematological and haemodynamic abnormalities preoperatively to try to improve outcome. Copyright © 1998 Taylor and Francis Ltd.</abstract><cop>UK</cop><pub>Taylor & Francis, Ltd</pub><pmid>9641367</pmid><doi>10.1080/110241598750004481</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1102-4151 |
| ispartof | The European journal of surgery, 1998-04, Vol.164 (4), p.263-270 |
| issn | 1102-4151 1741-9271 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_79961412 |
| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Alma/SFX Local Collection |
| subjects | Aged Aged, 80 and over Aortic Aneurysm, Abdominal - mortality Aortic Aneurysm, Abdominal - surgery Aortic Rupture - mortality Aortic Rupture - surgery Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Diseases of the aorta Female Hospital Mortality Humans Male Medical sciences Middle Aged Patient Selection Retrospective Studies Risk Factors Treatment Outcome |
| title | An "all comers" policy for ruptured abdominal aortic aneurysms: how can results be improved? |
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