Basnyat P S, Biffin A H, Moseley L G, Hedges A R, Lewis M H
East Glamorgan General Hospital, Pontypridd, UK.
Br J Surg. 1999 Jun;86(6):765-70. doi: 10.1046/j.1365-2168.1999.01170.x.
The aim of this study was to identify the incidence of, and mortality in, patients with a ruptured abdominal aortic aneurysm (AAA) reaching hospital alive in Wales.
Patients who presented with a ruptured AAA between September 1996 and August 1997 were analysed. Data were collected prospectively by an independent body, observing strict confidentiality.
Some 233 patients with a confirmed ruptured AAA were identified, giving an incidence of eight per 100 000 total population. Some 133 patients (57 per cent) underwent attempted operative repair; 85 (64 per cent) of these died within 30 days. Of the 233 patients, 92 were admitted under the care of a vascular surgeon and 141 under a non-vascular surgeon. Vascular surgeons operated on 82 patients (89 per cent), of whom 50 (61 per cent) died, whereas non-vascular surgeons operated on 51 patients (36 per cent), of whom 35 (69 per cent) died.
This study is unique as it is an independent prospective study of mortality in patients with a ruptured AAA who reached hospital alive. Mortality was independent of the operating surgeon, but vascular surgeons turned down significantly fewer patients than non-vascular surgeons (11 versus 64 per cent, P < 0.001).
本研究旨在确定威尔士腹主动脉瘤破裂（AAA）患者存活至医院的发病率和死亡率。
对1996年9月至1997年8月期间出现腹主动脉瘤破裂的患者进行分析。数据由一个独立机构前瞻性收集，并严格保密。
共确定了约233例确诊为腹主动脉瘤破裂的患者，发病率为每10万人中有8例。约133例患者（57%）接受了手术修复尝试；其中85例（64%）在30天内死亡。在这233例患者中，92例由血管外科医生负责治疗，141例由非血管外科医生负责治疗。血管外科医生为82例患者（89%）进行了手术，其中50例（61%）死亡，而非血管外科医生为51例患者（36%）进行了手术，其中35例（69%）死亡。
本研究具有独特性，因为它是对存活至医院的腹主动脉瘤破裂患者死亡率的独立前瞻性研究。死亡率与手术医生无关，但血管外科医生拒绝治疗的患者明显少于非血管外科医生（11%对64%，P<0.001）。
