A ruptured abdominal aortic aneurysm that requires preoperative cardiopulmonary resuscitation is not necessarily lethal

Pieter P.H.L. Broos, Yannick W. 't Mannetje, Maarten J.A. Loos, Marc R. Scheltinga, Lee H. Bouwman, Philippe W.M. Cuypers, Marc R.H.M. Van Sambeek, Joep A.W. Teijink

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)

Abstract

Objective A ruptured abdominal aortic aneurysm (RAAA) is associated with a high mortality rate. If cardiopulmonary resuscitation (CPR) is required before surgical repair, mortality rates are said to approach 100%. The aim of this multicenter, retrospective study was to study outcome in RAAA patients who required CPR before a surgical (endovascular or open) repair (CPR group). RAAA patients who did not need CPR served as controls (non-CPR group). Methods Over a 5-year time period, demographic and clinical characteristics and specifics of preoperative CPR if necessary were studied in all patients who were treated for a RAAA in three large, nonacademic hospitals. Results A total of 199 consecutive RAAA patients were available for analysis; 176 patients were surgically treated. Thirteen of these 176 patients (7.4%) needed CPR, and 163 (92.6%) did not. A 38.5% (5 of 13) survival rate was observed in the CPR group. Thirty-day mortality was almost three times greater in the CPR group compared with the non-CPR group (61.5% vs 22.7%; P =.005). Both CPR patients who received endovascular aortic repair survived. In contrast, survival in 11 CPR patients who underwent open RAAA repair was 27% (3 of 11; P =.128). A trend for higher Hardman index was found in patients who received CPR compared with patients who did not receive CPR (P =.052). The 30-day mortality in patients with a 0, 1, 2, or 3 Hardman index was 16.1%, 31.0%, 37.9%, and 33.3%, respectively (P =.093). Conclusions An RAAA that requires preoperative CPR is not necessarily a lethal combination. Patient selection must be tailored before surgery is denied.

Original languageEnglish
Pages (from-to)49-54
Number of pages6
JournalJournal of Vascular Surgery
Volume63
Issue number1
DOIs
Publication statusPublished - 1 Jan 2016
Externally publishedYes

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