Mortality rates associated with operative treatment of infrarenal abdominal aortic aneurysm in The Netherlands

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Abstract
Information on surgery for non-ruptured and ruptured infrarenal abdominal aortic aneurysm (AAA) in all hospitals in The Netherlands in 1990 was obtained from the Dutch National Medical Registration Foundation. The operation rate in the population over the age of 50 years was 30·3 per 100000 for non-ruptured AAA and 16·8 per 100000 for ruptured aneurysm. The hospital operative mortality rate for non-ruptured AAA surgery was 6·8 per cent in 1289 patients and for ruptured aneurysm 43·6 per cent in 709. For non-ruptured AAA the mortality rate almost doubled per age group of 10 years, whereas the influence of age was less significant for ruptured lesions. The operative mortality rate for non-ruptured aneurysm in university hospitals exceeded that in other hospitals, but no difference was found for emergency surgery on ruptured AAA. Nationwide results give a more representative picture of the true mortality rate associated with operation for aortic aneurysm. Such data are important for planning future treatment strategy and for evaluating the efficacy of screening.