Original CommunicationEffect of early plasma transfusion on mortality in patients with ruptured abdominal aortic aneurysm
Section snippets
Methods
All patients treated for RAAA at the University of Wisconsin between January 1, 1987 and December 31, 2007 were identified from either our institutional vascular database or through medical records review using ICD-9-CM codes. Only patients suffering massive hemorrhage were included, defined as those receiving 10 or more units of blood products from admission to the conclusion of the operation. This definition of massive hemorrhage was adapted from criteria described by Duchesne et al18
Results
Overall, 168 patients were treated for RAAA during the study period. Of this cohort, 128 (76%) patients met the criteria of massive hemorrhage. Mean age among the cohort was 73 ± 9 years, and 109 (85%) were men. Pre-existing comorbidities are shown in Table I. Although 18 (14%) patients were direct admissions, most (110, 86%) were transferred from other facilities. AAA had been diagnosed previously in 45 (35%) patients.
Historically at our institution, permissive hypotension was used for initial
Discussion
Our study exemplifies that repair of RAAA still incurs a substantial mortality. Most publications of large series report an operative mortality from 38% to 50%,1, 2, 3 with an overall mortality of up to 85% when including those who die prior to reaching an operating room.19 Factors affecting mortality have been documented broadly, and various reports have identified advanced age,7 female sex,7 preexisting renal insufficiency,20, 21 chronic obstructive lung disease,21 postoperative intestinal
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