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Vascular. 2009 Jan-Feb;17(1):9-14.

Effect of patient transfer on outcomes after open repair of ruptured abdominal aortic aneurysms.

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Department of Cardiothoracic and Vascular Surgery, University of Texas Health Science Center, Memorial Hermann Heart and Vascular Institute, Houston, TX, USA.


Patients with ruptured abdominal aortic aneurysms (RAAAs) benefit from treatment in high-volume facilities. This study explored the effect of patient transfer on outcomes and the relationship between hemodynamic status and mortality. We performed a retrospective review of 83 consecutive patients who had open repair for RAAA at a single tertiary facility. The patients were divided into two groups based on arrival in the local emergency department, "local" (n = 44) versus "transfer" (n = 39) from an outside institution, and into three categories of hemodynamic status: (a) no obtainable blood pressure, "pulseless"; (b) requiring vasopressor support, "pressors"; and (c) no vasopressor support, "no pressors." Thirty-day mortality was 21.4%. There was no difference in mortality between the local (18.2%) and transfer (25.6%) patients (p = .41). There were no deaths during transfer. There was no difference in the hemodynamic status of the transfer versus the local group (p = .34). The mortality by category was pulseless, 100% (3 of 3); pressors, 71.4% (10 of 14); and no pressors, 7.6% (5 of 66) (p < .0001). Actuarial survival was 66%, 64%, and 62% at 1, 3, and 5 years, respectively. Patient transfer does not adversely affect mortality after RAAA repair. Patients without a palpable pulse and those requiring hemodynamic support have a significantly higher mortality.

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