A Clinical Study on 306 Cases of Abdominal Aortic Aneurysm

This study was designed to clarify factors affecting hospital mortality and long-term prognosis after repair for abdominal aortic aneurysm (AAA). Subjects were 306 patients who underwent surgical repair for AAA from January 1987 through December 1996. There were 254 men and 52 women, aged between 44 and 86 years (an average of 70.3). A total of 65 patients required emergency repair for AAA, whereas 241 patients received elective repair. The hospital mortality rates were 2.1% in elective repairs and 36.9% in emergency repairs. The most influential factor associated with poor operative result in emergency repair was shock which represented about 50% of all death causes, followed by related acidosis. In a follow-up study of patients who survived operation, 5-year survival rates were 80.1% and 71.5% in elective and emergency repairs respectively. Both patients groups had favorable postopertive courses without significant difference as compared with those age and sex matched control. The risk factors for long-term prognosis included associated malignancy and thoracic aortic aneurysm in elective, and only renal dysfunction in emergency repairs. This study clarified that poor operative result was noted only after emergency repair for AAA in which shock was the determinant factor, and hence, to avoid shock would be of importance. But it is no doubt crucial to detect AAA early by screening and to perform elective surgery before rupture that causes a catastrophic condition.