Tadayon Niki, Mozafar Mohammad, Zarrintan Sina
Division of Vascular & Endovascular Surgery, Department of Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Health policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
J Cardiovasc Thorac Res. 2022;14(1):61-66. doi: 10.34172/jcvtr.2022.02. Epub 2022 Mar 6.
Ruptured abdominal aortic aneurysm (RAAA) is a catastrophic condition with in-hospital mortalities up to 89%. Patient survival depends on multiple factors; however, prompt surgery is essential to prevent mortality. We report the in-hospital outcomes of RAAA at a high-volume and teaching vascular surgery center in Iran. This study is a single-center retrospective analysis of patients with infrarenal RAAA during February 20, 2012 to December 21, 2019 at Shohada-Tajrish Medical Center, Tehran,Iran. We identified 66 patients with RAAA during the study period. The patients were dividedinto two groups based on their transfer status (Transfer group versus non-transfer group). The primary outcome was in-hospital death. The secondary outcomes were in-hospital myocardial infarction (MI), abdominal compartment syndrome (ACS) and postoperative renal dysfunction requiring dialysis. The mean age of the patients was 74.2 ± 8.3 years. Forty-seven patients (71.2%) were transferred to our center from other institutions. There were 46 in-hospital deaths (69.7%) and three in-hospital MIs (4.5%). Three patients (4.5%) had postoperative ACS and six patients (9.1%)had postoperative renal dysfunction requiring dialysis. Transfer patients had an increased rate of in-hospital death compared to non-transferred patients (76.6.1% versus 52.6%); however, the difference was not statistically significant ( =0.055). We found no significant different between operative mortality of transferred and non-transferred RAAA patients. Transfer of patients to tertiary centers with experienced vascular surgeons may delay the surgery. However, the transfer may be inevitable in areas where the optimal care of RAAA patients is not possible.
腹主动脉瘤破裂（RAAA）是一种灾难性疾病，院内死亡率高达89%。患者的生存取决于多种因素；然而，及时手术对于预防死亡至关重要。我们报告了伊朗一家高容量教学血管外科中心RAAA的院内结局。本研究是对2012年2月20日至2019年12月21日期间在伊朗德黑兰Shohada-Tajrish医疗中心的肾下腹主动脉瘤破裂患者进行的单中心回顾性分析。我们在研究期间确定了66例RAAA患者。根据患者的转运状态将其分为两组（转运组与非转运组）。主要结局是院内死亡。次要结局是院内心肌梗死（MI）、腹腔间隔室综合征（ACS）和术后需要透析的肾功能不全。患者的平均年龄为74.2±8.3岁。47例患者（71.2%）从其他机构转入我们中心。有46例院内死亡（69.7%）和3例院内心肌梗死（4.5%）。3例患者（4.5%）发生术后ACS，6例患者（9.1%）发生术后需要透析的肾功能不全。与未转运患者相比，转运患者的院内死亡率有所增加（76.6%对52.6%）；然而，差异无统计学意义（P=0.055）。我们发现转运和未转运的RAAA患者手术死亡率之间没有显著差异。将患者转运至有经验的血管外科医生的三级中心可能会延迟手术。然而，在无法对RAAA患者进行最佳治疗的地区，转运可能是不可避免的。
