Results of operations upon abdominal aortic aneurysms at a community hospital.

Review of a retrospective series of 140 consecutive abdominal aortic aneurysms in a community hospital has disclosed a low operative mortality and a low morbidity rate. Seventy patients were more than 70 years of age. Of 82 patients operated upon before rupture of the aneurysm, three died and 11 had complications. Of 38 patients operated upon after rupture of the aneurysm, 22 died and eight had complications. The age of 70 years or older and shock were identified as significant risk factors adversely affecting the outcome of operations done as an emergency upon patients with ruptured aneurysms. Renal failure occurred only in patients with ruptured aneurysms; when renal failure did occur, it was usually fatal. Myocardial infarction seldom occurred after elective operations because of aggressive, thorough cardiac evaluation, including selective coronary arteriography. Myocardial infarctions contributed to the deaths of six patients in whom the aneurysms ruptured prior to operation.