PMID- 20053527
OWN - NLM
STAT- MEDLINE
DCOM- 20100528
LR  - 20220331
IS  - 1615-5947 (Electronic)
IS  - 0890-5096 (Linking)
VI  - 24
IP  - 3
DP  - 2010 Apr
TI  - Prehospital treatment of infrarenal ruptured abdominal aortic aneurysms: a 
      multicentric analysis.
PG  - 308-14
LID - 10.1016/j.avsg.2009.08.011 [doi]
AB  - BACKGROUND: The aim of this study was to evaluate the quality of the current 
      treatment of patients presenting with ruptured abdominal aortic aneurysms 
      (RAAAs), from the first symptoms to the operating room with an analysis of 
      preoperative mortality risk factors. METHODS: For 3 years, in four vascular 
      surgery departments, we have collected all the consecutive cases of patients 
      operated on for RAAA. We analyzed the initial clinical situation, the means of 
      transportation, the time elapsed before treatment, and the mortality rate at 3 
      days. Sixty-six RAAAs were operated on. Mean patient age was 76 years (range, 
      52-93 years). RESULTS: The initial symptoms were a precisely located pain either 
      abdominal (45.3%), lumbar (17.2%), or both (14.1%) or feeling faint (10.9%). In 
      22.7% of the cases, an initial hemodynamic instability was observed. In 46.8% of 
      the cases, patients first went to a peripheral hospital before being admitted 
      into a referral centre. In 84.5% of the cases, medical mean of transportation was 
      used. The mean distance covered was 59.8 kilometers (range, <5 km to 213 km). The 
      initial diagnosis was accurate in 67.3% of the cases. The mean intrahospital 
      waiting period between the arrival at a reference center and the admission into 
      an operating room was 127 minutes. Global mortality rate was 44.2%. The main 
      preoperative mortality factor to be noticed was the initial hemodynamic 
      instability (p=0.0031). Among stable patients, only two of them (5.4%) worsened 
      during the preoperative treatment. CONCLUSION: In our study, hemodynamic 
      instability corresponds to the main prognosis factor of mortality. In most cases, 
      the initial stability persisted and allowed additional evaluation. However, the 
      intrahospital waiting periods appeared to be too long. To be optimal, the 
      adequate treatment should be specifically designed as soon as a diagnosis has 
      been established.
CI  - Copyright (c) 2010 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All 
      rights reserved.
FAU - Rinckenbach, Simon
AU  - Rinckenbach S
AD  - Service de Chirurgie Vasculaire, Hopital Jean Minjoz, CHU de Besancon, Besancon 
      Cedex, France. srinckenbach@chu-besancon.fr
FAU - Albertini, Jean-Noel
AU  - Albertini JN
FAU - Thaveau, Fabien
AU  - Thaveau F
FAU - Steinmetz, Eric
AU  - Steinmetz E
FAU - Camin, Amelie
AU  - Camin A
FAU - Ohanessian, Lionel
AU  - Ohanessian L
FAU - Monassier, Francois
AU  - Monassier F
FAU - Clement, Claude
AU  - Clement C
FAU - Brenot, Roger
AU  - Brenot R
FAU - Camelot, Gabriel
AU  - Camelot G
FAU - Chakfe, Nabil
AU  - Chakfe N
FAU - Kretz, Jean-Georges
AU  - Kretz JG
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Multicenter Study
DEP - 20100106
PL  - Netherlands
TA  - Ann Vasc Surg
JT  - Annals of vascular surgery
JID - 8703941
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Aneurysm, Abdominal/diagnosis/mortality/physiopathology/surgery/*therapy
MH  - Aortic Rupture/diagnosis/mortality/physiopathology/surgery/*therapy
MH  - Blood Vessel Prosthesis Implantation/adverse effects/mortality
MH  - Chi-Square Distribution
MH  - *Emergency Medical Services
MH  - Female
MH  - France
MH  - *Health Services Accessibility
MH  - *Hemodynamics
MH  - Hospitals, University
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Admission
MH  - *Quality of Health Care
MH  - Referral and Consultation
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Transportation of Patients
MH  - Treatment Outcome
EDAT- 2010/01/08 06:00
MHDA- 2010/05/29 06:00
CRDT- 2010/01/08 06:00
PHST- 2008/01/28 00:00 [received]
PHST- 2009/08/18 00:00 [revised]
PHST- 2009/08/27 00:00 [accepted]
PHST- 2010/01/08 06:00 [entrez]
PHST- 2010/01/08 06:00 [pubmed]
PHST- 2010/05/29 06:00 [medline]
AID - S0890-5096(09)00255-6 [pii]
AID - 10.1016/j.avsg.2009.08.011 [doi]
PST - ppublish
SO  - Ann Vasc Surg. 2010 Apr;24(3):308-14. doi: 10.1016/j.avsg.2009.08.011. Epub 2010 
      Jan 6.