Time to IMPROVE the management of ruptured abdominal aortic aneurysm: IMPROVE trialists.

摘要

Without intervention, ruptured AM is fatal and the overall mortality exceeds 85%. Many patients with ruptured aneurysms die in the community. Half, or more, of those patients arriving in Accident & Emergency may not reach the operating theatre alive. Among the patients who reach the operating theatre (for open surgical repair under general anaesthesia), only about half will leave hospital alive. These stark figures have changed little over the last 50 years. Moreover, the incidence of both elective and ruptured AAA continues to increase year on year. Routine treatment has been to direct patients suspected of having a ruptured aneurysm directly to the operating theatre for open repair, often without confirmation of diagnosis with pre-operative CT scan.