{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:28:11Z","timestamp":1761060491401},"reference-count":22,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,12,30]],"date-time":"2017-12-30T00:00:00Z","timestamp":1514592000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,12,30]],"date-time":"2017-12-30T00:00:00Z","timestamp":1514592000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The available literature on ruptured abdominal aortic aneurysms (rAAA) centers on survival after operation and commonly, reasons why some patients do not undergo surgery are not addressed. The aim of the present study is to examine, in a population\u2010based cohort, the characteristics, stratification and time to death of patients admitted to hospital, but not undergoing operation for rAAA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective, single\u2010center study. All patients admitted to Stavanger University Hospital from the primary catchment area with rAAA on admission or in\u2010hospital from 2000 to 2014 were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Altogether 214 patients with rAAA were identified; 57 (27%) patients did not undergo surgery. The proportion of women was significantly higher (37 vs. 14%; <jats:italic>p<\/jats:italic> &lt;. 001) in patients not having surgery. The reasons for not undergoing operation were patient \u2018not fit for surgery\u2019 (30%), \u2018dying or agonal\u2019 at time of diagnosis (26%), \u2018did not want operation\u2019 (21%) and \u2018diagnosed at autopsy\u2019 (23%). Of the non\u2010operated patients, 45 had rAAA on arrival to hospital, 12 had in\u2010hospital rupture and 21 patients had previously been diagnosed with an abdominal aortic aneurysm. Non\u2010operative treatment was uniformly fatal. The 45 patients with rAAA on arrival were scored using four scoring systems, the predicted mortality varied widely, and the median time from admission to death was 7.4 h (range 0\u20131337).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In about half of patients, a decision not to operate was made by the consultant vascular surgeon or the patient. In the subgroup of patients not diagnosed until autopsy or having an in\u2010hospital rupture, an earlier diagnosis might have altered the outcome.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-017-4445-1","type":"journal-article","created":{"date-parts":[[2017,12,29]],"date-time":"2017-12-29T23:02:51Z","timestamp":1514588571000},"page":"2269-2276","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Characteristics, Stratification and Time to Death in a Population\u2010Based Cohort of Patients with Ruptured Abdominal Aortic Aneurysms Not Undergoing Surgery"],"prefix":"10.1002","volume":"42","author":[{"given":"Morten","family":"Vetrhus","sequence":"first","affiliation":[{"name":"Department of Surgery, Vascular Surgery Unit Stavanger University Hospital PO Box 8100 4068 Stavanger 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