Proctor, V.K., Lee, M.J. orcid.org/0000-0001-9971-1635 and Nassef, A.H. (2017) Outcomes of regional transfers of ruptured abdominal aortic aneurysm in a UK vascular network. Annals of The Royal College of Surgeons of England, 99 (1). pp. 88-92. ISSN 0035-8843
Abstract
INTRODUCTION Rupture of abdominal aortic aneurysm is a surgical emergency. In order to improve operative outcomes, vascular services have been centralised in the United Kingdom. This means that a patient may present to a hospital with a ruptured aneurysm, but require transfer to a vascular centre for definitive treatment.
METHODS This retrospective cohort study identified patients who underwent surgery for ruptured abdominal aortic aneurysm in a tertiary vascular centre over a 2-year period. Data on demographics and originating unit were recorded. Outcomes assessed included 30-day mortality, operative mortality and postoperative morbidity.
RESULTS We identified 70 patients who underwent surgery for ruptured abdominal aortic aneurysm in the 2-year period; 36 presented directly to the vascular unit (VU), 14 to referral unit 1 (RU1) and 20 to referral unit 2 (RU2); 30-day mortality rates were 27.7% (VU), 35.5% (RU1) and 30.0% (RU2), respectively. There was no statistical difference in mortality between units. Postoperative complications were seen in 35.9% of VU patients, 78.6% of RU1 patients and 70% of RU2 patients. This was statistically significant between VU and RU1 (P = 0.006) and VU and RU2 (P = 0.02). Direct operative complications were seen in 9 patients, gastrointestinal complications in 9, limb complications in 6 and systemic complications in 40.
CONCLUSION This study found that site of presentation does not affect mortality but is associated with increased morbidity. This is a complex issue, which will require a prospective multicentre study to investigate further.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2016 The Royal College of Surgeons of England. |
Keywords: | Abdominal aortic aneurysm; Ruptured aneurysm; Transfer; Complications |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > The Medical School (Sheffield) > Academic Unit of Medical Education (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 22 Apr 2020 09:33 |
Last Modified: | 22 Apr 2020 09:33 |
Status: | Published |
Publisher: | Royal College of Surgeons of England |
Refereed: | Yes |
Identification Number: | 10.1308/rcsann.2016.0231 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:159750 |