Hoornweg L L, Storm-Versloot M N, Ubbink D T, Koelemay M J W, Legemate D A, Balm R
Department of Vascular surgery, Academic Medical Center, Amsterdam, The Netherlands.
Eur J Vasc Endovasc Surg. 2008 May;35(5):558-70. doi: 10.1016/j.ejvs.2007.11.019. Epub 2008 Jan 15.
To assess the mortality of patients with ruptured abdominal aortic aneurysms undergoing open surgery and examine changes in mortality over time.
Literature databases were searched for relevant articles published between 1991 and 2006. Two reviewers independently performed study inclusion and data extraction. Primary outcome measure was 30 day or in-hospital mortality. Subgroup analyses were performed examining the effect of population- and hospital-based studies, hospital volume and type of surgeon.
From a total of 1419 identified studies, 145 observational studies met the inclusion criteria of which 116 were included in the systematic review comprising 60,822 patients. Overall mortality was 48.5% (95% CI: 48.1-48.9%) and did not change significantly over the years. Age increased over the years. For overall mortality a trend was seen in favour of high-volume hospitals.
This meta-analysis suggests that mortality of patients with RAAA treated by open surgery has not changed over the past 15 years. This could be explained by increased age of patients undergoing RAAA repair.
评估接受开放手术的腹主动脉瘤破裂患者的死亡率，并研究死亡率随时间的变化。
检索1991年至2006年间发表的相关文献数据库。两名评审员独立进行研究纳入和数据提取。主要结局指标为30天或住院死亡率。进行亚组分析以研究基于人群和医院的研究、医院规模以及外科医生类型的影响。
在总共1419项识别出的研究中，145项观察性研究符合纳入标准，其中116项纳入系统评价，共60822例患者。总体死亡率为48.5%（95%可信区间：48.1 - 48.9%），多年来无显著变化。患者年龄逐年增加。总体死亡率显示出倾向于大型医院的趋势。
这项荟萃分析表明，过去15年中接受开放手术治疗的腹主动脉瘤破裂患者的死亡率没有变化。这可能是由于接受腹主动脉瘤修复手术的患者年龄增加所致。
