Elective abdominal aortic aneurysm operations--the results of a single surgeon series of 243 consecutive operations from a district general hospital

• Published in: Annals of the Royal College of Surgeons of England Vol. 82; no. 1; pp. 64 - 68
• Main Authors: Humphreys, W V, Byrne, J, James, W
• Format: Journal Article
• Language: English
• Published: England Royal College of Surgeons of England 01.01.2000
• Subjects: Aged; Aged, 80 and over; Aortic Aneurysm, Abdominal - surgery; Female; Hospitals, District; Hospitals, General; Humans; Male; Medical Audit; Middle Aged; Postoperative Complications - mortality; Prospective Studies; Retrospective Studies; Treatment Outcome; Wales - epidemiology; Wales
• ISSN: 0035-8843; 1478-7083

There are few data on the morbidity and mortality of planned elective surgery for infrarenal abdominal aortic aneurysm (AAA) as a single surgeon series. This audit is of a consecutive series of AAA operations performed by one surgeon in one district general hospital over a 13-year period. 243 patients were operated on for AAA between 1985 and 1998. Data were collected on the majority of patients prospectively. A reliable method was devised to identify all patients. Any missing complication and mortality data were then collected retrospectively. 13 patients died as a result of their operation (5.3%). In patients over the age of 80 years (36), five patients died (14%) and in the 207 patients under the age of 80 years, eight died (3.8%). Cardiac deaths were the most frequent cause (38%); 82 patients had recorded complications (34%). The operative mortality rate has increased in later years, (2.2% to 7.1%), largely due to an increase in the very elderly accepted for operation (12% to 16%), and a possible increase in co-morbidity. An acceptable and comparable mortality rate can be achieved in a district general hospital. The complication rate is high indicating the need for very intense medical and nursing care for these patients postoperatively. There is a considerable variance in mortality rates with age and risk even in the practice of one surgeon, indicating a need to be very knowledgeable and cautious in interpreting postoperative mortality data. This is the largest single surgeon series to date in the UK.