Humphreys W V, Byrne J, James W
Department of Vascular Surgery and Anaesthetics, Ysbyty Gwynedd, Bangor, Gwynedd, UK.
Ann R Coll Surg Engl. 2000 Jan;82(1):64-8.
There are few data on the morbidity and mortality of planned elective surgery for infrarenal abdominal aortic aneurysm (AAA) as a single surgeon series. This audit is of a consecutive series of AAA operations performed by one surgeon in one district general hospital over a 13-year period.
243 patients were operated on for AAA between 1985 and 1998. Data were collected on the majority of patients prospectively. A reliable method was devised to identify all patients. Any missing complication and mortality data were then collected retrospectively.
13 patients died as a result of their operation (5.3%). In patients over the age of 80 years (36), five patients died (14%) and in the 207 patients under the age of 80 years, eight died (3.8%). Cardiac deaths were the most frequent cause (38%); 82 patients had recorded complications (34%). The operative mortality rate has increased in later years, (2.2% to 7.1%), largely due to an increase in the very elderly accepted for operation (12% to 16%), and a possible increase in co-morbidity.
An acceptable and comparable mortality rate can be achieved in a district general hospital. The complication rate is high indicating the need for very intense medical and nursing care for these patients postoperatively. There is a considerable variance in mortality rates with age and risk even in the practice of one surgeon, indicating a need to be very knowledgeable and cautious in interpreting postoperative mortality data. This is the largest single surgeon series to date in the UK.
作为单个外科医生的系列病例，关于肾下腹主动脉瘤（AAA）择期手术的发病率和死亡率的数据很少。本次审计是对一名外科医生在一家地区综合医院13年间连续进行的一系列AAA手术的情况进行的。
1985年至1998年间，对243例患者进行了AAA手术。前瞻性收集了大多数患者的数据。设计了一种可靠的方法来识别所有患者。然后回顾性收集任何缺失的并发症和死亡率数据。
13例患者因手术死亡（5.3%）。80岁以上的患者（36例）中有5例死亡（14%），80岁以下的207例患者中有8例死亡（3.8%）。心脏死亡是最常见的原因（38%）；82例患者记录有并发症（34%）。近年来手术死亡率有所上升（从2.2%升至7.1%），主要是由于接受手术的高龄患者增加（从12%升至16%），以及合并症可能增加。
在地区综合医院可以实现可接受且具有可比性的死亡率。并发症发生率很高，表明这些患者术后需要非常 intensive 的医疗和护理。即使在一名外科医生的实践中，死亡率也因年龄和风险存在相当大的差异，这表明在解释术后死亡率数据时需要非常了解情况并谨慎。这是英国迄今为止最大的单个外科医生系列病例。 （注：intensive 在这里结合语境应是“强化的、深入细致的”意思，但原文未翻译完整，推测可能是录入有误。）
