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February 1, 1992British journal of surgery

Age-standardized incidence of ruptured aortic aneurysm in a defined Swedish population between 1952 and 1988: mortality rate and operative results

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Why the study?

Does treatment by specialized vascular surgeons improve operative outcomes compared to general surgeons in patients with ruptured aortic aneurysm?

Population

Defined and stable Swedish population between 1952 and 1988

Comparison

Treatment by specialized vascular surgeons vs Treatment by non-specialized general surgeons

Design

Cohort

Follow-up

1952-1988

Authors

CDChrister DrottUniversity of CopenhagenBABerndt ArfvidssonÖrebro University HospitalPÖPer ÖrtenwallLinköping University

Discussion

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Overview

Rising abdominal aortic aneurysm rupture rates and mortality support enhanced surveillance; observational data leave open whether vascular specialization improves outcomes.

Key Points

  • To determine long-term incidence and mortality trends for ruptured aortic aneurysms and compare operative outcomes between specialized vascular surgeons and general surgeons.
  • Evaluated incidence and age-standardized mortality rates of ruptured abdominal and thoracic aortic aneurysms in a defined Swedish population between 1952 and 1988.
  • Compared operative parameters and survival across surgical specialties, assessing blood loss, transfusion needs, aortic clamp time, total operation time, and graft selection.
  • Abdominal aneurysm rupture rates rose from 0.9 to 6.9 per 100,000 inhabitants, with age-standardized mortality increasing 2.4% annually between 1960 and 1988 (95% CI, 1.2–3.6%; P = 0.0004), whereas age-adjusted thoracic aneurysm mortality remained stable.
  • Overall mortality for ruptured abdominal aneurysms reached 85% in the 1980s, with 52% of deaths occurring outside surgical clinics, 37% reaching the operating room, and 30% undergoing aortic reconstruction.
  • Vascular surgeons achieved lower mortality, reduced blood loss, lower transfusion needs, shorter aortic clamp and operative times, and higher rates of completed reconstruction using straight grafts compared to general surgeons.

Structured PICO

Does treatment by specialized vascular surgeons improve operative outcomes compared to general surgeons in patients with ruptured aortic aneurysm?

P
Population
Defined and stable Swedish population between 1952 and 1988
I
Intervention
Treatment by specialized vascular surgeons
C
Comparator
Treatment by non-specialized general surgeons
O
Outcome
Incidence and mortality rate of ruptured aortic aneurysmhard clinical

The incidence and mortality of ruptured abdominal aortic aneurysms increased significantly in Sweden from 1952 to 1988, and operative outcomes were superior when performed by specialized vascular surgeons.

Cite This Study

Drott et al. (1992) studied this question.

synapsesocial.com/papers/6a79ec6d14b028facf0e0ed6https://doi.org/10.1002/bjs.1800790228
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Ruptured abdominal aortic aneurysms: A study of incidence and mortality1986 · 241 citations
  2. 2Impact of vascular surgery on community mortality from ruptured aortic aneurysms1986 · 226 citations
  3. 3Ten-year review of non-ruptured aortic aneurysms1989 · 35 citations
  4. 4Abdominal aortic aneurysm1988 · 97 citations
  5. 5Increasing incidence of aortic aneurysms in England and Wales.1989 · 226 citations