Surgical repair of ruptured abdominal aortic aneurysms in the state of Maryland: Factors influencing outcome among 527 recent cases

A. Dardik, G. P. Burleyson, H. Bowman, Toby A Gordon, G. M. Williams, T. H. Webb, Bruce Alan Perler, J. G. Robison

Research output: Contribution to journalArticle

Abstract

Purpose: Abdominal aortic aneurysm (AAA) rupture has been historically associated with high operative mortality rates. In this community-based, cross-sectional study, we examined factors influencing outcome after operations performed for ruptured AAA (rAAA). Methods: An analysis of a state database identified 3820 patients who underwent AAA repair between 1990 and 1995, including 527 (13.8%) who had an operation for an rAAA. Demographic variables examined included patient age, gender, race, associated comorbidity rates, operative surgeon experience with rAAA, and annual hospital rAAA and total AAA operative volumes. Outcomes measured included operative mortality rates, hospital length of stay, and charges. Results: Operative mortality rates increased significantly with advancing age (P <0.0001) but were not related to gender (P = 0.474) or race (p = 0.598) and were significantly lower among patients with hypertension (P = 0.006) or pulmonary disease (P = 0.045). There was no relationship between hospital rAAA or total AAA volume and rAAA repair mortality rate, although high-volume surgeons (i.e., performing more than 10 rAAA repairs) had decreased mortality rates and hospital charges compared with other surgeons. Hospital lengths of stay and charges increased with age among survivors, but not nonsurvivors, of rAAA repair. Despite a stable incidence of rAAA repairs during the study interval and no significant change in the mean age of patients undergoing operation or the percentage of operations performed by high-volume surgeons, the statewide mortality rate declined from 59.3% to 43.2% (P = 0.039). Conclusion: The incidence of rAAA does not appear to be declining. Although operative rAAA repair continues to be associated with substantial risk and remains an especially lethal condition among the elderly, the operative mortality rate has declined in recent years in Maryland. Lower operative mortality rates and hospital charges are associated with operations performed by high-volume surgeons.

Original languageEnglish (US)
Pages (from-to)413-421
Number of pages9
JournalJournal of Vascular Surgery
Volume28
Issue number3
DOIs
StatePublished - 1998

Fingerprint

Aortic Rupture
Abdominal Aortic Aneurysm
Hospital Charges
Mortality
Length of Stay
Incidence
Lung Diseases
Survivors
Comorbidity
Cross-Sectional Studies
Demography
Surgeons
Databases
Hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Surgical repair of ruptured abdominal aortic aneurysms in the state of Maryland : Factors influencing outcome among 527 recent cases. / Dardik, A.; Burleyson, G. P.; Bowman, H.; Gordon, Toby A; Williams, G. M.; Webb, T. H.; Perler, Bruce Alan; Robison, J. G.

In: Journal of Vascular Surgery, Vol. 28, No. 3, 1998, p. 413-421.

Research output: Contribution to journalArticle

Dardik, A. ; Burleyson, G. P. ; Bowman, H. ; Gordon, Toby A ; Williams, G. M. ; Webb, T. H. ; Perler, Bruce Alan ; Robison, J. G. / Surgical repair of ruptured abdominal aortic aneurysms in the state of Maryland : Factors influencing outcome among 527 recent cases. In: Journal of Vascular Surgery. 1998 ; Vol. 28, No. 3. pp. 413-421.
@article{86df581505ec4d04843e26eb041f96ba,
title = "Surgical repair of ruptured abdominal aortic aneurysms in the state of Maryland: Factors influencing outcome among 527 recent cases",
abstract = "Purpose: Abdominal aortic aneurysm (AAA) rupture has been historically associated with high operative mortality rates. In this community-based, cross-sectional study, we examined factors influencing outcome after operations performed for ruptured AAA (rAAA). Methods: An analysis of a state database identified 3820 patients who underwent AAA repair between 1990 and 1995, including 527 (13.8{\%}) who had an operation for an rAAA. Demographic variables examined included patient age, gender, race, associated comorbidity rates, operative surgeon experience with rAAA, and annual hospital rAAA and total AAA operative volumes. Outcomes measured included operative mortality rates, hospital length of stay, and charges. Results: Operative mortality rates increased significantly with advancing age (P <0.0001) but were not related to gender (P = 0.474) or race (p = 0.598) and were significantly lower among patients with hypertension (P = 0.006) or pulmonary disease (P = 0.045). There was no relationship between hospital rAAA or total AAA volume and rAAA repair mortality rate, although high-volume surgeons (i.e., performing more than 10 rAAA repairs) had decreased mortality rates and hospital charges compared with other surgeons. Hospital lengths of stay and charges increased with age among survivors, but not nonsurvivors, of rAAA repair. Despite a stable incidence of rAAA repairs during the study interval and no significant change in the mean age of patients undergoing operation or the percentage of operations performed by high-volume surgeons, the statewide mortality rate declined from 59.3{\%} to 43.2{\%} (P = 0.039). Conclusion: The incidence of rAAA does not appear to be declining. Although operative rAAA repair continues to be associated with substantial risk and remains an especially lethal condition among the elderly, the operative mortality rate has declined in recent years in Maryland. Lower operative mortality rates and hospital charges are associated with operations performed by high-volume surgeons.",
author = "A. Dardik and Burleyson, {G. P.} and H. Bowman and Gordon, {Toby A} and Williams, {G. M.} and Webb, {T. H.} and Perler, {Bruce Alan} and Robison, {J. G.}",
year = "1998",
doi = "10.1016/S0741-5214(98)70126-0",
language = "English (US)",
volume = "28",
pages = "413--421",
journal = "Journal of Vascular Surgery",
issn = "0741-5214",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - Surgical repair of ruptured abdominal aortic aneurysms in the state of Maryland

T2 - Factors influencing outcome among 527 recent cases

AU - Dardik, A.

AU - Burleyson, G. P.

AU - Bowman, H.

AU - Gordon, Toby A

AU - Williams, G. M.

AU - Webb, T. H.

AU - Perler, Bruce Alan

AU - Robison, J. G.

PY - 1998

Y1 - 1998

N2 - Purpose: Abdominal aortic aneurysm (AAA) rupture has been historically associated with high operative mortality rates. In this community-based, cross-sectional study, we examined factors influencing outcome after operations performed for ruptured AAA (rAAA). Methods: An analysis of a state database identified 3820 patients who underwent AAA repair between 1990 and 1995, including 527 (13.8%) who had an operation for an rAAA. Demographic variables examined included patient age, gender, race, associated comorbidity rates, operative surgeon experience with rAAA, and annual hospital rAAA and total AAA operative volumes. Outcomes measured included operative mortality rates, hospital length of stay, and charges. Results: Operative mortality rates increased significantly with advancing age (P <0.0001) but were not related to gender (P = 0.474) or race (p = 0.598) and were significantly lower among patients with hypertension (P = 0.006) or pulmonary disease (P = 0.045). There was no relationship between hospital rAAA or total AAA volume and rAAA repair mortality rate, although high-volume surgeons (i.e., performing more than 10 rAAA repairs) had decreased mortality rates and hospital charges compared with other surgeons. Hospital lengths of stay and charges increased with age among survivors, but not nonsurvivors, of rAAA repair. Despite a stable incidence of rAAA repairs during the study interval and no significant change in the mean age of patients undergoing operation or the percentage of operations performed by high-volume surgeons, the statewide mortality rate declined from 59.3% to 43.2% (P = 0.039). Conclusion: The incidence of rAAA does not appear to be declining. Although operative rAAA repair continues to be associated with substantial risk and remains an especially lethal condition among the elderly, the operative mortality rate has declined in recent years in Maryland. Lower operative mortality rates and hospital charges are associated with operations performed by high-volume surgeons.

AB - Purpose: Abdominal aortic aneurysm (AAA) rupture has been historically associated with high operative mortality rates. In this community-based, cross-sectional study, we examined factors influencing outcome after operations performed for ruptured AAA (rAAA). Methods: An analysis of a state database identified 3820 patients who underwent AAA repair between 1990 and 1995, including 527 (13.8%) who had an operation for an rAAA. Demographic variables examined included patient age, gender, race, associated comorbidity rates, operative surgeon experience with rAAA, and annual hospital rAAA and total AAA operative volumes. Outcomes measured included operative mortality rates, hospital length of stay, and charges. Results: Operative mortality rates increased significantly with advancing age (P <0.0001) but were not related to gender (P = 0.474) or race (p = 0.598) and were significantly lower among patients with hypertension (P = 0.006) or pulmonary disease (P = 0.045). There was no relationship between hospital rAAA or total AAA volume and rAAA repair mortality rate, although high-volume surgeons (i.e., performing more than 10 rAAA repairs) had decreased mortality rates and hospital charges compared with other surgeons. Hospital lengths of stay and charges increased with age among survivors, but not nonsurvivors, of rAAA repair. Despite a stable incidence of rAAA repairs during the study interval and no significant change in the mean age of patients undergoing operation or the percentage of operations performed by high-volume surgeons, the statewide mortality rate declined from 59.3% to 43.2% (P = 0.039). Conclusion: The incidence of rAAA does not appear to be declining. Although operative rAAA repair continues to be associated with substantial risk and remains an especially lethal condition among the elderly, the operative mortality rate has declined in recent years in Maryland. Lower operative mortality rates and hospital charges are associated with operations performed by high-volume surgeons.

UR - http://www.scopus.com/inward/record.url?scp=0031694386&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031694386&partnerID=8YFLogxK

U2 - 10.1016/S0741-5214(98)70126-0

DO - 10.1016/S0741-5214(98)70126-0

M3 - Article

C2 - 9737450

AN - SCOPUS:0031694386

VL - 28

SP - 413

EP - 421

JO - Journal of Vascular Surgery

JF - Journal of Vascular Surgery

SN - 0741-5214

IS - 3

ER -