Infrarenal aortic aneurysm surgery in a rural surgical service: risk factors for mortality.

Abstract

An audit of both the emergency and elective abdominal aortic surgery that was performed in a rural surgical service, was carried out. Retrospective data analysis was performed on 41 patients who were treated for abdominal aortic aneurysms (AAA) during an 8-year period from 1989 to 1996. Postoperative outcomes were analysed with respect to patient age, mode of presentation (elective or emergency), transfusion requirements and pre-existing cardiac and respiratory disease. Univariate analysis was performed using Fisher's exact test, and the odds ratio for adverse outcome was calculated. A postoperative mortality rate of 5.8% in elective repairs and 68% in cases of rupture was noted. Pre-existing respiratory disease, transfusion requirements of more than six units and presentation with retroperitoneal leak or rupture correlated with postoperative mortality, while age and pre-existing cardiac disease were shown not to be predictive of adverse outcome following surgery. An overall improvement in operative outcomes in the institution (Wimmera Base Hospital) that was audited would be affected by earlier referral for elective repair in selected patients. Like others, the authors believe that age on its own is not a contraindication to elective AAA repair.