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Ruptured Abdominal Aortic Aneurysms in the 1990s: Resource Utilization, Long-Term Survival, and Quality of Life After Repair

Division of Vascular Surgery and Department of Anesthesiology, The University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

Stephen A. Bowles, MD

Critical Care Medicine, The University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

Marshall W. Webster, MD

David L. Steed, MD

Michel S. Makaroun, MD

Satish C. Muluk, MD

Robert Y. Rhee, MD

Division of Vascular Surgery and Department of Anesthesiology, The University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

Lakshmipathi Chelluri, MD, MPH

Critical Care Medicine, The University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

Ruptured abdominal aortic aneurysm (RAAA) is a lethal disease. The aim of this study was to assess resource use, long-term outcome, and functional status of patients surviving repair of RAAAs. A retrospective review was made over a 42-month period. Functional status was assessed by use of the Medical Outcomes Study Short Form 36 (MOS SF-36) at a mean follow-up time of 29 months. Fifty-seven patients with an RAAA underwent surgical repair. The overall in-hospital mortality rate after surgical repair was 39%. Risk factors predictive for a poor hospital outcome were preoperative systolic blood pressure less than 90 mmHg, hematocrit less than 25%, transfusion requirements greater than 15 units, renal failure, and need for perioperative cardiopulmonary resuscitation (CPR). Total hospital costs were significantly higher for survivors compared with nonsurvivors. Hospital cost per survivor was $86,977. Intensive Care Unit, laboratory, and blood bank costs accounted for 50% of total hospital costs. Based on the eight domains of the MOS SF-36, no significant difference was found between the functional status of those patients surviving emergent repair of RAAAs and that of the general population of a similar age.

Vascular and Endovascular Surgery, Vol. 32, No. 5, 415-424 (1998)
DOI: 10.1177/153857449803200503


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