Mortality From Ruptured Abdominal Aortic Aneurysms in Southern Saskatchewan

Nick Peti, BSc.; David Kopriva MDCM, FRCS(C); Donald J McCarville MD, FRCS(C)

The Regina Qu’Appelle Health Region (RQHR) provides all specialist vascular care for southern Saskatchewan and portions of south-western Manitoba. A chart review was undertaken on all cases of ruptured abdominal aortic aneurysms (rAAA) presenting to the RQHR between March 1, 1996 and February 28, 2006. One hundred and one cases of rAAA presented to the RQHR over this ten year period. Thirty seven percent of patients presented with blood pressure below 90 mmHg systolic. Seven percent had no recordable blood pressure. The overall mortality was 25%. Seven patients were treated paliatively and 94 had open surgical repair of rAAA. The operative patients suffered 19% mortality. The mortality rate for rAAA seen in the RQHR is below the rate reported in the medical literature even though our patient demographics are comparable to other series. Mortality risk was not statistically different for patients presenting within the city of Regina and those presenting from a greater distance. We postulate that our favourable mortality risk implies that a large number of the most unstable cases of rAAA in southern Saskatchewan die in the community without the benefit of specialist evaluation in the RQHR. Further education of primary care physicians and patients might lead to the salvage of some of these patients.