A prospective survey of patients presenting with abdominal aortic aneurysm

Objectives: To define the presentation and management of patients presenting with abdominal aortic aneurysm (AAA) Design and setting: A prospective survey was carried out of all patients presenting to hospitals within the Oxford region. Materials and methods: Data were collected by one surgeon in each hospital. Full details were collected onto data sheets. Results: One hundred and ninety patients presented, 141 electively, 46 with ruptured AAA and three with acute AAAs. In 53 patients presenting electively the aneurysm was small and surveillance started. Fifty-six patients underwent an operation, three patients died. Of 46 patients with a ruptured aneurysm 24 (52%) died. In 11 no operation was carried out and all of these patients died within 24 h. Operative mortality was 13 of 35 patients (37%). Move patients with a ruptured AAA were transferred to the teaching hospital compared with a district general hospital (p<0.05). This was reflected in a lower operative mortality in the teaching hospital. Conclusions: The presentation of AAA in this study was approximately 15 per 100000 population. Approximately one-third of patients presenting electively had small AAAs which required surveillance. A further third underwent an operation, the remaining patients being unfit. Approximately one-quarter of patients with a ruptured aneurysm did not undergo an operation. The operative mortality was 37%.