March 1994

Invited Commentary

Author Affiliations

Louisville, Ky

Arch Surg. 1994;129(3):290. doi:10.1001/archsurg.1994.01420270066015

THE ARTICLE by Katz and kohl1 focuses on the problem of ruptured abdominal aortic aneurysms in a discrete geographic area served by three hospitals in an 8-year period. The mortality rate was 57%, which was similar to the 49% mortality rate reported in a study of all Medicare patients undergoing operation in Kentucky in a single year.2 The authors noted that technical errors were identified in 15 cases, resulting in a 93% mortality rate, and implied that inexperience was a major cause of preventable mortality. The results of our study showed a trend toward increasing complications in surgeons who performed few aneurysm operations, but the number of ruptured aneurysms was too small to allow for valid statistical comparison.

Although the operative records of all patients operated on for ruptured aneurysms were reviewed, our study could not define specific errors in technique in a clearly defined fashion as Drs Katz

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