Aortic aneurysm death risk hinges on choice of surgeon, study finds

ANN ARBOR, MI If the largest blood vessel in your body threatens to burst, a new study finds that your best bet is to have it repaired by a surgeon who has operated on many other patients with the same condition. If you do, your risk of dying before you leave the hospital will be far lower than it would be with a less-experienced surgeon.

And your best bet, the study finds, is a surgeon who specializes in surgery on blood vessels, called a vascular surgeon. If you can't find one, at least try to go to a surgeon or a hospital with a high level of experience performing the tricky procedure.

These conclusions come from a new study by researchers from the University of Michigan Cardiovascular Center and published in the October issue of the Journal of Vascular Surgery. It's the first comprehensive national analysis of the differences in mortality risk for repair of intact abdominal aortic aneurysms, or AAAs, by surgeon specialty and experience, and hospital experience.

"The bottom line is that with a complex operation like this, experience counts," says senior author Gilbert R. Upchurch, Jr., M.D., an assistant professor of vascular surgery at the U-M Medical School. "And the experience of the individual surgeon may count even more than the sheer number of AAA operations at an individual hospital. This is important for individual patients, as well as policy makers, to realize."

More than 175,000 Americans are diagnosed with AAAs every year, most while the aneurysm is still intact. Tens of thousands have surgery to repair the weakened vessel wall, either electively, immediately post-diagnosis for severe problems, or after the aneurysm ruptures. Less than half of patients who suffer a rupture survive. In all, 16,000 people died from AAA-related causes each year.

The study looked at records from 3,912 Americans of all ages who had surgery to repair an intact AAA in 1997. The data are from the Nationwide Inpatient Sample, which samp

Contact: Kara Gavin
University of Michigan Health System

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