Fate of patients unwilling or unsuitable to undergo surgical intervention for a ruptured abdominal aortic aneurysm

Eur J Vasc Endovasc Surg. 2015 Feb;49(2):163-5. doi: 10.1016/j.ejvs.2014.10.007. Epub 2014 Dec 24.

Abstract

Introduction: The primary objective of this study was to assess the duration of in-hospital survival in 57 patients with ruptured abdominal aortic aneurysms (RAAA) who did not undergo surgical intervention.

Report: Two hours after registration in the emergency room, 58% (95% CI 45-71) of patients were still alive. The median survival was 2.2 hours (interquartile range 1-18). In a subgroup including 26 haemodynamically stable patients, survival after 2 hours was 96% (95% CI 89-100).

Conclusion: In patients with an RAAA without surgical intervention, the duration of in-hospital survival is limited. However, a group of haemodynamically stable patients can be identified in whom survival is much longer.

Keywords: Abdominal; Aneurysm; Aortic aneurysm; Nonoperative therapy; Ruptured; Ruptured abdominal aortic aneurysm; Vascular surgical procedures; Withholding treatment.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm, Abdominal / diagnosis
  • Aortic Aneurysm, Abdominal / mortality
  • Aortic Aneurysm, Abdominal / physiopathology
  • Aortic Aneurysm, Abdominal / therapy*
  • Aortic Rupture / diagnosis
  • Aortic Rupture / mortality
  • Aortic Rupture / physiopathology
  • Aortic Rupture / therapy*
  • Contraindications
  • Female
  • Hemodynamics
  • Hospital Mortality
  • Humans
  • Male
  • Netherlands
  • Retrospective Studies
  • Survival Analysis
  • Time Factors
  • Time-to-Treatment
  • Treatment Outcome
  • Treatment Refusal*
  • Vascular Surgical Procedures*