Crawford E S, Saleh S A, Babb J W, Glaeser D H, Vaccaro P S, Silvers A
Ann Surg. 1981 Jun;193(6):699-709. doi: 10.1097/00000658-198106000-00005.
This report is concerned with the factors influencing survival in 920 consecutive patients submitted to operation for infrarenal abdominal aortic aneurysm during the past 25 years. Rupture had occurred in 60 patients (6.5%) and survival was 77%, which did not vary during the period of study. Of the 860 patients (93.5%) treated for nonrupture, 819 (95%) survived operation. The mortality rate in this group varied from 18%, in the earlier period to 1.43% , in recent years. Risk factors including heart disease, hypertension, and advanced age accounted for 95% of the deaths that occurred within 30 days however, the mortality rate in patients with these problems decreased from 19.2% to 1.9% during the period of study although the average number of patients treated each year with these risk factors increased tenfold. Improvements in operative techniques and experience were responsible for decreasing mortality up to about 1971. Subsequent decrease in mortality was due to improvements in anesthesia, monitoring, and other supportive measures during operation and the early recovery period. Complete survival information was obtained in 816 (99.6%) patients, 191 of whom had been treated for periods over 15 years. Factors influencing long-term survival were associated disease and age at time of operation. Survival in percentage in patients without associated heart disease of hypertension for 5, 10, and 15 years was 84, 49, and 21; with heart disease, it was 54, 34, and 17. The median age of patients in the series was 65.5 years and survival at above intervals according to quartile was less than or equal to 60; 71, 53, and 24; 60 less than age less than or equal to 71; 66, 38, and 18; less greater than 71; 43, 13, and 11.
本报告关注过去25年间920例因肾下腹主动脉瘤接受手术的连续患者的生存影响因素。60例患者（6.5%）发生了破裂，生存率为77%，在研究期间无变化。860例（93.5%）非破裂患者中，819例（95%）手术存活。该组死亡率从早期的18%降至近年来的1.43%。包括心脏病、高血压和高龄在内的危险因素占30天内死亡病例的95%，然而，尽管每年接受这些危险因素治疗的患者数量增加了10倍，但研究期间有这些问题的患者死亡率从19.2%降至1.9%。手术技术和经验的改进使死亡率在1971年左右之前有所下降。随后死亡率的下降归因于手术期间和早期恢复期麻醉、监测及其他支持措施的改善。816例（99.6%）患者获得了完整的生存信息，其中191例接受治疗超过15年。影响长期生存的因素是相关疾病和手术时的年龄。无相关心脏病或高血压患者5年、10年和15年的生存率分别为84%、49%和21%；有心脏病的患者分别为54%、34%和17%。该系列患者的中位年龄为65.5岁，按四分位数划分，上述时间段的生存率在年龄小于或等于60岁时分别为小于或等于60%、71%、53%和24%；60岁至71岁时分别为66%、38%和18%；大于71岁时分别为43%、13%和11%。
