Aneurisma da aorta abdominal – estudo epidemiológico de doentes tratados num centro por um período de 8 anos com o objetivo de promover o rastreio populacional

Introduction

The rupture of an AAA is frequently fatal and accounts for nearly 1% of all deaths. Open surgical intervention is associated with high mortality, but EVAR (Endovascular Aneurysm Repair) is far from consensual owing to lack of level A evidence. Screening is cost effective in male patients over the age of 65 with a 44% reduction in AAA related mortality. This retrospective study had two endpoints, the first was the global assessment of care for both elective and urgent aneurysms in our institution. The second was raising awareness in local primary health care institutions for both the dismal prognosis of untreated AAA and the favorable prognosis of patients treated electively, using outcome data from our centre.

Methods

Data was extracted from the hospital database concerning urgent and elective repair of AAA from 2007 to 2014.

Results

Over the 8 year period, 155 elective aneurysm repairs were performed, 108 through open surgery and 47 through EVAR (with an increasing percentage with time). The early (30 days) mortality rate was 1.3%. We performed 51 aneurysm repairs for ruptured aneurysms (46 open surgery and 5 EVAR), with an intra‐operative mortality of 15.7% and early mortality of 47%. Concerning the geographic distribution of elective and urgent cases, we identified a tendency for assimetry in the distribution of elective and urgent repair of aneurysms. Unfortunately, due to lack of data concerning treatment of patients from our referral area in other centres and pre hospital mortality of ruptured aneurysms, no true incidence rates were possible to calculate.

Conclusions

The outcome of patients treated in our institution are comparable with data from literature We disclosed this data to all local primary health care institutions as well as the established recommendations for screening, with the final purpose of raising awareness for the active role they must have in the screening of AAA and treatment of this patients by controlling cardiovascular risk factors.