Key result
For patients surviving at least 30 days, long-term survival following open repair of ruptured abdominal aortic aneurysm was similar to elective repair (P=0.98) and the general population (P=0.23).
Why the study?
Does open repair of ruptured abdominal aortic aneurysm result in similar long-term survival compared to elective repair or an age-matched population in patients surviving at least 30 days?
Cohort (n=320)
No
Does open repair of ruptured abdominal aortic aneurysm result in similar long-term survival compared to elective repair or an age-matched population in patients surviving at least 30 days?
p-value: p=0.98
For patients surviving at least 30 days, open repair of ruptured AAA provides long-term survival comparable to elective repair and the general age-matched population.
Reassuring survival data for RAAA survivors; hypothesis-generating and should not yet change practice.
BACKGROUND: Long-term results for patients being managed for ruptured compared to elective abdominal aortic aneurysms (AAA) are unclear. We hypothesize that patients who survive 30 days or more following repair of ruptured AAA (RAAA) performed by open technique have a life expectancy no different to those patients surviving 30 days or more following elective AAA repair, or compared to a general age-matched population. METHODS: Between 1987 and December 2014, 620 consecutive patients were treated by the principal author for aortic aneurysmal disease. Two subgroups were selected from this population, elective open abdominal repair (215) and RAAA open repair (105). Comparable age-matched life curves with the general population were used from the Australian Bureau of Statistics for each patient according to gender, age and date of presentation. Statistical comparison was by Kaplan-Meier survival analysis. RESULTS: Both the open and RAAA groups were well matched for age and sex. There was no statistical difference between RAAA survival and an age-matched population P = 0.23, or was there any difference between open repair and an age-matched population, P = 0.1. Survival curves for RAAA and open repair were similar, P = 0.98. For elective open repair 1-, 5-, 10-, 15- and 20-year survival was 93.6, 71.2, 40, 17 and 2% respectively. Corresponding results for RAAA were 92.5, 74, 36.7, 13.5 and 5% respectively. CONCLUSION: Open AAA repair for RAAA or elective aneurysm treatment restores predicted life expectancy for those patients surviving 30 days or more and is therefore a durable method of treatment for this condition.
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Englund et al. (2016) conducted a cohort in Abdominal aortic aneurysm (n=320). Open repair of ruptured abdominal aortic aneurysm vs. Elective open repair and age-matched general population was evaluated on Long-term survival (p=0.98). For patients surviving at least 30 days, long-term survival following open repair of ruptured abdominal aortic aneurysm was similar to elective repair (P=0.98) and the general population (P=0.23).
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