Yildirim Hilin, van Lammeren Guus W, Ünlü Çagdas, van Dongen Eric P, van de Mortel Rob Hw, de Vries Jean-Paul Pm
1 Department of Vascular Surgery, St. Antonius Hospital, Nieuwegein, the Netherlands.
2 Department of Vascular Surgery, Noordwest Hospital Group, Alkmaar, the Netherlands.
Vascular. 2018 Jun;26(3):231-238. doi: 10.1177/1708538117727360. Epub 2017 Aug 22.
Objectives To evaluate long-term outcome and quality of life after open and endovascular repair of ruptured abdominal aortic aneurysms. Methods All consecutive ruptured abdominal aortic aneurysm patients at the St. Antonius Hospital treated for ruptured abdominal aortic aneurysm between January 2005 and January 2015 were included. Mortality, morbidity, and re-interventions within 30 days and during follow-up were registered. Quality of life was measured with Short Form-36 questionnaire among survivors. Additional subgroup analysis between open repair and endovascular repair was performed. Results A total of 192 patients with ruptured abdominal aortic aneurysm were included: 76.6% (147/192) underwent open repair and 23.4% (45/192) endovascular repair. All-cause 30-day mortality rate was 31.3% (60/192), and 30-day morbidity rate was 70.3% (135/192). Median stay at the intensive care unit was two days for endovascular repair and four days for open repair ( p = 0.002). No other statistically significant differences between endovascular repair and open repair were observed. After a mean follow-up period of 62 months (range 9-126), 72.4% (76/105) of the responders had equivalent Short Form-36 scores as compared to the age-matched general Dutch population, and 84.2% (64/76) of the responders would choose surgery again if they would have a ruptured abdominal aortic aneurysm. Conclusions Survivors of ruptured abdominal aortic aneurysm have similar long-term quality of life scores compared to the age-matched general population. The majority of all survivors would choose to undergo acute abdominal aortic aneurysm repair again.
目的 评估破裂腹主动脉瘤开放修复和血管腔内修复后的长期结局及生活质量。方法 纳入2005年1月至2015年1月在圣安东尼乌斯医院接受破裂腹主动脉瘤治疗的所有连续性破裂腹主动脉瘤患者。记录30天内及随访期间的死亡率、发病率和再次干预情况。在幸存者中用简明健康状况调查问卷（Short Form-36 questionnaire）测量生活质量。对开放修复和血管腔内修复进行额外的亚组分析。结果 共纳入192例破裂腹主动脉瘤患者：76.6%（147/192）接受开放修复，23.4%（45/192）接受血管腔内修复。全因30天死亡率为31.3%（60/192），30天发病率为70.3%（135/192）。血管腔内修复患者在重症监护病房的中位住院时间为2天，开放修复患者为4天（p = 0.002）。血管腔内修复和开放修复之间未观察到其他统计学上的显著差异。平均随访62个月（范围9 - 126个月）后，72.4%（76/105）的应答者与年龄匹配的荷兰普通人群相比，简明健康状况调查问卷得分相当，84.2%（64/76）的应答者如果再次发生破裂腹主动脉瘤会选择再次手术。结论 与年龄匹配的普通人群相比，破裂腹主动脉瘤幸存者的长期生活质量得分相似。所有幸存者中的大多数会选择再次接受急性腹主动脉瘤修复手术。
