AbuRahma A F, Woodruff B A, Lucente F C, Stuart S P, Boland J P
Department of Surgery, West Virginia University Health Sciences Center/Charleston Area Medical Center.
Surg Gynecol Obstet. 1991 May;172(5):377-82.
The hospital records for patients treated for ruptured abdominal aortic aneurysms in southern West Virginia during a recent five year period were reviewed. The over-all mortality rate was 62 per cent. Patients with intraperitoneal rupture had a higher mortality rate (97 per cent) than patients with retroperitoneal rupture (25 per cent). Patients at increased risk were more than 80 years of age, presented with syncope, experienced a short duration of symptoms before seeking medical attention, had preoperative systolic blood pressure levels of less than 90 millimeters of mercury and had a preoperative hemoglobin level of less than 8. Other factors associated with death were a delay in beginning surgical treatment, a larger total blood loss and amount of blood transfused. The results of multivariate analysis demonstrated that preoperative blood pressure, preoperative hemoglobin, presence of syncope and the amount of blood loss were, in large part, reflections of the type of rupture and had only slight independent relationship to mortality. The most effective method of preventing fatal outcome is elective resection of the aneurysms before rupture occurs.
回顾了西弗吉尼亚州南部近期五年内接受腹主动脉瘤破裂治疗的患者的医院记录。总体死亡率为62%。腹腔内破裂患者的死亡率（97%）高于腹膜后破裂患者（25%）。高危患者年龄超过80岁，出现晕厥，在就医前症状持续时间短，术前收缩压低于90毫米汞柱，术前血红蛋白水平低于8。与死亡相关的其他因素包括手术治疗开始延迟、总失血量和输血量较大。多变量分析结果表明，术前血压、术前血红蛋白、晕厥的存在以及失血量在很大程度上反映了破裂类型，与死亡率仅有轻微的独立关系。预防致命结局的最有效方法是在动脉瘤破裂前进行择期切除。
