Drott C, Arfvidsson B, Ortenwall P, Lundholm K
Department of Surgery, Central Hospital, Borås, Sweden.
Br J Surg. 1992 Feb;79(2):175-9. doi: 10.1002/bjs.1800790228.
The incidence and mortality rate of ruptured aortic aneurysm in a defined and stable Swedish population was determined for the period 1952-1988. The annual rupture rate of abdominal aneurysm rose significantly from 0.9 per 100,000 inhabitants in the 1950s to 6.9 in the 1980s. After standardization for age, the mortality rate increased between 1960 and 1988 by 2.4 per cent annually (95 per cent confidence interval 1.2-3.6 per cent, P = 0.0004). Comparable figures from the UK during the 1980s have been reported to be two to three times higher. The mortality rate of ruptured thoracic aneurysm in the Swedish population did not increase when adjusted for age. In the 1980s the overall mortality rate of ruptured abdominal aneurysm was 85 per cent. Death occurred outside surgical clinics in 52 per cent of cases; 37 per cent of the total number of patients with ruptured aneurysm reached the operating table but only 30 per cent underwent aortic reconstruction. Patients treated by vascular surgeons had lower blood loss and transfusion needs, shorter aortic clamp time and operation time, and lower mortality rate than patients treated by non-specialized general surgeons. Specialized vascular surgeons also completed the reconstruction, and used straight grafts, in a higher proportion of cases than general surgeons.
确定了1952年至1988年期间瑞典一个特定稳定人群中主动脉瘤破裂的发病率和死亡率。腹主动脉瘤的年破裂率从20世纪50年代的每10万居民0.9例显著上升至20世纪80年代的6.9例。在对年龄进行标准化后，1960年至1988年期间死亡率每年上升2.4%（95%置信区间为1.2% - 3.6%，P = 0.0004）。据报道，20世纪80年代英国的可比数据要高出两到三倍。瑞典人群中破裂胸主动脉瘤的死亡率在调整年龄后没有增加。20世纪80年代，破裂腹主动脉瘤的总体死亡率为85%。52%的病例在外科诊所外死亡；37%的动脉瘤破裂患者总数到达了手术台，但只有30%接受了主动脉重建。与非专业普通外科医生治疗的患者相比，血管外科医生治疗的患者失血量和输血需求更低，主动脉阻断时间和手术时间更短，死亡率也更低。与普通外科医生相比，专业血管外科医生在更高比例的病例中完成了重建并使用了直型移植物。
