Document Detail


Treatment delays for patients exiting an aortic aneurysm surveillance programme.
MedLine Citation:
PMID:  18269477     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We have previously reported abdominal aortic aneurysm (AAA)-related mortality in patients who have completed surveillance. This study investigates the journey time of patients who exited the AAA surveillance programme at Christchurch Hospital and underwent elective repair to determine the factors contributing to the interval between completing surveillance and undergoing surgical repair. METHODS: A retrospective review of patient notes was carried out for 25 patients who underwent elective repair of their AAA after exiting the surveillance programme between November 2000 and September 2005. RESULTS: The median time interval between exiting the programme and undergoing repair for patients fit for repair was 6 months. During this waiting period, there were two aneurysm-related deaths. Analysis of the patient journeys showed that those with significant comorbidity, that is, patients who required additional investigation by other clinicians (n = 7), had a median time to repair of 35 weeks. This was substantially increased compared with a median time of 22.5 weeks to repair for the rest (n = 18). CONCLUSION: At our institution the median time for completion of surveillance to repair was 6 months. An AAA with a diameter of 55 mm has an expected risk of rupture of 5%, with mortality approaching 90%. In our series, mortality was 4.9% (two patients died while awaiting repair), consistent with expected figures. Factors contributing to this delay of 6 months to repair were identified. Modifications to this journey are suggested to improve the time interval and therefore hopefully reduce the aneurysm-related mortality in this group.
Authors:
Byron J Oram; Timothy M Buckenham; Justin A Roake; David R Lewis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  ANZ journal of surgery     Volume:  78     ISSN:  1445-2197     ISO Abbreviation:  ANZ J Surg     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-13     Completed Date:  2008-03-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101086634     Medline TA:  ANZ J Surg     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  148-50     Citation Subset:  IM    
Affiliation:
Department of Radiology, Christchurch Hospital, Christchurch, New Zealand.
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MeSH Terms
Descriptor/Qualifier:
Adult
Angioplasty / adverse effects,  methods
Aortic Aneurysm, Abdominal / mortality,  radiography*,  surgery*
Female
Follow-Up Studies
Humans
Male
Mass Screening / organization & administration*
Middle Aged
New Zealand
Patient Selection
Retrospective Studies
Risk Assessment
Severity of Illness Index
Surgical Procedures, Elective / adverse effects,  methods*
Survival Rate
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Vascular Surgical Procedures / adverse effects,  methods
Waiting Lists*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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