Mortality in abdominal aortic aneurysm surgery — The effect of hospital volume, patient mix and surgeon's case load

Objective:Assessment of mortality in abdominal aortic aneurysm surgery.Design:A 4-year cross sectional study based on a nationwide vascular registry: Finnvasc.Material and Methods:A total of 17 465 vascular interventions included 929 elective repairs for abdominal aortic aneurysms (AAA), and 610 emergency cases with 454 ruptures. Fifty-three percent of the operations were done in university hospitals, 44% in central hospitals and 3% in district hospitals.Results:The 30-day mortality rate for AAA repair was 5.1% in elective and 46% in ruptured cases. A clear dependence of operative mortality on surgeon's experience in AAA surgery was observed, both regarding the surgeon's total vascular case load (p<0.01) and the number of operated elective aneurysms (p