Prognosis of patients over 75 years of age with a ruptured abdominal aortic aneurysm.

Forty-seven patients (34 males and 13 females) over 75 years of age (mean: 79.7 +/- 3.8 SD) suffering from a ruptured abdominal aortic aneurysm were operated on between 1977 and 1986. In 16 patients (34%), the aneurysm had been diagnosed previously. Seventeen patients (36%) had a delay of 6 hours or more in the beginning of the treatment and 26 (55%) were in shock preoperatively. The mean diameter of the aneurysms was 8.9 +/- 2.6 cm (SD) and the mean operative bleeding was 8.5 +/- 7.8 (SD) liters. The mean operating time was 220 +/- 96 (SD) minutes. The 1-month mortality was 60% (28 patients) and 63% (12 patients) of survivors had postoperative complications, mostly pneumonia. The 5-year survival rate was 26%. In the analysis of risk factors associated with death, preoperative shock, old age, and a previously diagnosed but untreated abdominal aortic aneurysm were associated with a significantly worse prognosis.