AAA Surgery Outcome Depends on Choice of Surgeon

A study has found that the best surgical outcome for an abdominal aortic aneurysm (AAA) occurs when the surgeon has operated on many other AAA patients and specializes in vascular surgery. The study was published in the October 2003 issue of the Journal of Vascular Surgery.

Researchers reviewed the records of 3,912 patients who had surgery to repair an intact AAA in 1997. They classified each surgeon as a vascular, cardiac, or general surgeon based on the number of different types of operations each performed that year. No matter what their specialty, they were classified as high-volume surgeons if they repaired more than 10 AAAs in a year. Hospitals were also classified according to how many AAA repairs were performed in them. High-volume hospitals had more than 35 AAA operations in a year.

The results showed that, overall, only 4.2% of patients who had AAA surgery died before they left the hospital. However, only 2.2% of patients operated on by vascular surgeons died, compared with 4% for cardiac surgeons and 5.5% for general surgeons. Patients operated on by a high-volume surgeon of any kind had a 40% lower chance of dying than those with low-volume surgeons. The best surgical outcomes were found in patients who had surgery at high-volume hospitals by high-volume surgeons of any type.

"It looks like the differences in mortality and risk-adjusted mortality have something to do with the specific skill of operating on blood vessels, and the extent to which a surgeon and surgical team is able to practice that skill on many patients,” said senior author Gilbert R. Upchurch, Jr., M.D., assistant professor of vascular surgery at the University of Michigan Medical School (Ann Arbor, MI, USA).




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University of Michigan Medical School