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Characteristics and Outcome of Abdominal Aortic Aneurysm in Emregncy Department; a 10-year Cross-sectional Study

Mohammad Mehdi Forouzanfar, Fatemeh Barazesh, Behrooz Hashemi, Saeed Safari
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Abstract

Introduction: Abdominal aortic aneurysm (AAA, triple A) is one of the less common but important causes of abdominal pain. This study aimed to evaluate the characteristics and outcome of patients presenting to emergency department with triple A.

Methods: In this retrospective cross-sectional study, all cases with confirmed triple A, who were presented to the emergency department of Shohadaye Tajrish Hospital, Tehran, Iran from 2006 to 2017 (10 years) were enrolled using census sampling method.

Results: 500 cases with the mean age of 68.11 ± 11.98 (25 - 94) years were studied (84% male). The mean duration of symptoms was 2.32 ± 9.58 months and mean aneurysmal size was 63.91 ± 20.08 mm. In 4 (0.8 %) cases, atrial fibrillation (AF) was found during cardiac monitoring. Patients stayed in the hospital for an average of 7.06 ± 6.32 days. Aneurysmal leak was seen in 130 (26%) cases based on abdominal computed tomography (CT) scan findings. 369 (73.8%) cases underwent aneurysmorrhaphy, 126 (25.2%) were treated with non-surgical approaches, and 5 (1%) underwent grafting. 104 (20.8%) died and 396 (79.2%) were treated successfully. Older age (p = 0.017), shock state at the time of presentation (p < 0.0001), leakage of aneurysm (p < 0.001), larger size of aneurysm (p = 0.024), and aneurysmorrhaphy (p < 0.001) were among the factors significantly associated with mortality.

Conclusion: Based on the findings, the most frequent presenting symptom of patients was abdominal pain. The mortality rate of this series was 21% and older age, shock state, leakage of aneurysm, larger size of aneurysm, and performing aneurysmorrhaphy were among the factors significantly associated with mortality.


Keywords

Aortic aneurysm, abdominal; abdominal pain; iliac aneurysm; outcome assessment

References

Lo RC, Schermerhorn ML. Abdominal aortic aneurysms in women. Journal of vascular surgery. 2016;63(3):839-44.

Kontopodis N, Lioudaki S, Pantidis D, Papadopoulos G, Georgakarakos E, Ioannou CV. Advances in determining abdominal aortic aneurysm size and growth. World journal of radiology. 2016;8(2):148-58.

Gianfagna F, Veronesi G, Bertù L, Tozzi M, Tarallo A, Ferrario M, et al. Prevalence of abdominal aortic aneurysms and its relation with cardiovascular risk stratification: protocol of the Risk of Cardiovascular diseases and abdominal aortic Aneurysm in Varese (RoCAV) population based study. BMC cardiovascular disorders. 2016;16(1):243.

Sakalihasan N, Limet R, Defawe OD. Abdominal aortic aneurysm. The Lancet. 2005;365(9470):1577-89.

Ogata T, MacKean GL, Cole CW, Arthur C, Andreou P, Tromp G, et al. The lifetime prevalence of abdominal aortic aneurysms among siblings of aneurysm patients is eightfold higher than among siblings of spouses: an analysis of 187 aneurysm families in Nova Scotia, Canada. Journal of vascular surgery. 2005;42(5):891-7.

Visser P, Akkersdijk G, Blankensteijn J. In-hospital operative mortality of ruptured abdominal aortic aneurysm: a population-based analysis of 5593 patients in The Netherlands over a 10-year period. European journal of vascular and endovascular surgery. 2005;30(4):359-64.

Heller JA, Weinberg A, Arons R, Krishnasastry K, Lyon RT, Deitch JS, et al. Two decades of abdominal aortic aneurysm repair: have we made any progress? Journal of vascular surgery. 2000;32(6):1091-100.

Prinssen M, Verhoeven EL, Buth J, Cuypers PW, van Sambeek MR, Balm R, et al. A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms. New England Journal of Medicine. 2004;351(16):1607-18.

Mirsharifi R, Zhand N, Shahriyarian S, Meysamie A, Mirsharifi A, Aminian A. The prevalence of abdominal aortic aneurysm in Iranian male population over 65 years old. Tehran University Medical Journal. 2011;69(5):322-6.

Kuivaniemi H, Ryer EJ, Elmore JR, Tromp G. Understanding the pathogenesis of abdominal aortic aneurysms. Expert review of cardiovascular therapy. 2015;13(9):975-87.

Chabok M, Nicolaides A, Aslam M, Farahmandfar M, Humphries K, Kermani N, et al. Risk factors associated with increased prevalence of abdominal aortic aneurysm in women. British Journal of Surgery. 2016;103(9):1132-8.

Tang W, Yao L, Roetker NS, Alonso A, Lutsey PL, Steenson CC, et al. Lifetime risk and risk factors for abdominal aortic aneurysm in a 24-year prospective study: the ARIC study (atherosclerosis risk in communities). Arteriosclerosis, thrombosis, and vascular biology. 2016;36(12):2468-77.

Yuan H, Han X, Jiao D, Zhou P, editors. A Case-Control Study of Risk Factors of Abdominal Aortic Aneurysm. The heart surgery forum; 2016.

Giribono AM, Ferrara D, Spalla F, Narese D, Bracale U, Pecoraro F, et al. Endovascular treatment of spontaneous isolated abdominal aortic dissection. Acta radiologica open. 2016;5(12):2058460116681042.




DOI: https://doi.org/10.22037/aaem.v8i1.529

DOI (PDF): https://doi.org/10.22037/aaem.v8i1.529.g681

DOI (HTML): https://doi.org/10.22037/aaem.v8i1.529.g701