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Comparison of long-term survival after repair of ruptured and non-ruptured abdominal aortic aneurysm.

Late survival rates were compared and analysed for 1070 patients undergoing repair of ruptured infrarenal abdominal aortic aneurysm (RAAA, n = 364, mean age 70.0 years, male:female ratio 5.6:1) and non-ruptured abdominal aortic aneurysm (AAA, n = 706, mean age 66.6 years, male: female ratio 5.4:1) between January 1970 and July 1992 at the Department of Thoracic and Cardiovascular Surgery of Helsinki University Central Hospital, Finland. There was a statistically significant difference in survival rates between the RAAA and AAA groups during the first three months after repair of abdominal aortic aneurysm. Operative mortality rates were 7.4% for electively repaired abdominal aortic aneurysms and 48.7% for ruptured abdominal aortic aneurysms. For 3-month postoperative survivors there existed no statistically significant difference in late survival rates, nor did these rates differ from those of an age- and sex-matched population. Five-year survival rates for 3-month postoperative survivors were 60% in the RAAA group and 67% in the AAA group. Median survival time was 5.7 years and 7.5 years, respectively. Coronary artery disease, hypertension, chronic obstructive pulmonary disease and renal insufficiency statistically significantly reduced late survival rates after 3 months post-surgery for non-ruptured abdominal aortic aneurysm, whereas these risk factors did not alter late prognosis after successful repair of ruptured abdominal aortic aneurysm. Cerebrovascular disease reduced late survival rates both in AAA (median survival time 6.3 years) and RAAA group (median survival time 4.9 years). Of late deaths 41% were caused by coronary artery disease in the AAA group and 38% in the RAAA group.(ABSTRACT TRUNCATED AT 250 WORDS)