Mortality in abdominal aortic aneurysm surgery - The effect of hospital volume, patient mix and surgeon's case load

Objective: Assessment of mortality in abdominal aortic aneurysm surgery. Design: A 4-year cross sectional study based on a nationwide vascular registry: Finnvasc. Material ann Methods: A total of 17465 vascular interventions included 929 elective repairs for abdominal aortic aneurysms (AAAI, and 610 emergency cases with 454 ruptures. Fifty-three percent of the operations were done in university hospitals, 44% in central hospitals and 3% in district hospitals. Results: The 30-day mortality rate for AAA repair tons 5.1% in elective and 46% in ruptured cases. A clear dependence of operative mortality on surgeon's experience in AAA surgery was observed, both regarding the surgeon's total vascular case load (p<0.01) and the number of operated elective aneurysms (p<0.01), but not the number of operated ruptured aneurysms. However, no association was found between hospital volume and mortality in AAA surgery. Conclusions: Vascular surgical experience clearly improves the results of elective aneurysm surgery.