Sudden unexpected deaths from ruptured abdominal aortic aneurysms

Abstract

The first successful resection of an abdominal aortic aneurysm was carried out in 1951.' Interest in these aneurysms has increased since then; ~ several studies have reported an increase in the incidence of ruptured abdominal aortic aneurysms (RAAAs) over the last few years. 1,34 For patients with RAAAs, surgery is the only hope of survival, 7 however 55-86% of all RAAA deaths occur before any attempts at treatment can be madeY ,8-1° The mortality rate for patients undergoing surgical repair of a ruptured aneurysm ranges from 55-68%, 3,~,8-1° compared with 3-8% for elective repair of a non-ruptured aneurysm? ,8,H The frequency of sudden death from these aneurysms, defined as death in which the RAAA is first diagnosed at a postmortem examination, is not accurately known? The postmortem records at the University of Edinburgh's Forensic Medicine Unit (FMU) provide a useful source of information for these deaths as they cover all uncertified sudden and unexplained deaths occurring in Lothian Region in the South East of Scotland and in the Borders. The aims of this study were: (1) to establish the number of deaths from RAAAs as recorded by the Edinburgh University FMU, (2) to describe the characteristics of this cohort of patients and (3) to compare these features with other published series of patients dying from RAAAs.