PMID- 19046648
OWN - NLM
STAT- MEDLINE
DCOM- 20090212
LR  - 20090127
IS  - 1532-2165 (Electronic)
IS  - 1078-5884 (Linking)
VI  - 37
IP  - 2
DP  - 2009 Feb
TI  - An emergency EVAR service reduces mortality in ruptured abdominal aortic 
      aneurysms.
PG  - 189-93
LID - 10.1016/j.ejvs.2008.11.002 [doi]
AB  - OBJECTIVES: The aim of this study was to compare all in-hospital mortality for 
      ruptured abdominal aortic aneurysms (rAAAs) before and after the establishment of 
      an emergency EVAR (eEVAR) service. DESIGN AND METHODS: An eEVAR service was 
      established in January 2006, since when all patients presenting with rAAAs have 
      been considered for endovascular repair. Data for all rAAAs presenting between 
      January 2006 and December 2007 was prospectively collected (Group 1). This 
      patient group was compared to those presenting with rAAA between January 2003 and 
      December 2005 when eEVAR was not offered at our institution (Group 2). These 
      records had also been collected prospectively and submitted to the National 
      Vascular Database (NVD). RESULTS: A total of 50 rAAAs (17 eEVAR, 29 open repairs, 
      4 palliated) presented after the introduction of eEVAR (Group 1) and 71 in the 
      historical Group 2 of which 54 underwent open repair and 17 were palliated. The 
      total in-hospital mortality was significantly lower in Group 1 20% (eEVAR (n=1), 
      6%: Open (n=5), 17%: palliated (n=4), 100%) when compared to Group 2 54% (Open 
      (n=21), 39%: palliated (n=17), 100%) (p=0.000001). Furthermore similar 
      significant differences were seen in 30-day operative mortalities between the two 
      groups 13% in Group 1 versus 39% in Group 2 (p=0.0003). In addition the 
      proportion of patients who were palliated has significantly decreased (8% Group 1 
      versus 24% Group 2, p=0.01). CONCLUSIONS: The establishment of an eEVAR service 
      has significantly reduced in-hospital mortality for patients presenting with 
      ruptured abdominal aortic aneurysms.
FAU - Sadat, U
AU  - Sadat U
AD  - Cambridge Vascular Unit, Addenbrooke's Hospital, Hills Road, Cambridge, UK.
FAU - Hayes, P D
AU  - Hayes PD
FAU - Kullar, P J
AU  - Kullar PJ
FAU - Cousins, C
AU  - Cousins C
FAU - Varty, K
AU  - Varty K
FAU - Boyle, J R
AU  - Boyle JR
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20081201
PL  - England
TA  - Eur J Vasc Endovasc Surg
JT  - European journal of vascular and endovascular surgery : the official journal of 
      the European Society for Vascular Surgery
JID - 9512728
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Aneurysm, Abdominal/complications/*mortality/*surgery
MH  - Aortic Rupture/*mortality/*surgery
MH  - Blood Loss, Surgical
MH  - Blood Vessel Prosthesis Implantation/adverse effects/instrumentation/*mortality
MH  - Databases as Topic
MH  - Emergency Treatment/*mortality
MH  - Hospital Mortality
MH  - Humans
MH  - Length of Stay
MH  - Palliative Care
MH  - Postoperative Hemorrhage/etiology
MH  - Program Evaluation
MH  - Prospective Studies
MH  - Treatment Outcome
EDAT- 2008/12/03 09:00
MHDA- 2009/02/13 09:00
CRDT- 2008/12/03 09:00
PHST- 2008/03/03 00:00 [received]
PHST- 2008/11/03 00:00 [accepted]
PHST- 2008/12/03 09:00 [pubmed]
PHST- 2009/02/13 09:00 [medline]
PHST- 2008/12/03 09:00 [entrez]
AID - S1078-5884(08)00580-7 [pii]
AID - 10.1016/j.ejvs.2008.11.002 [doi]
PST - ppublish
SO  - Eur J Vasc Endovasc Surg. 2009 Feb;37(2):189-93. doi: 10.1016/j.ejvs.2008.11.002. 
      Epub 2008 Dec 1.