Quality indicators in the treatment of abdominal aortic aneurysms

Objective: In this overview quality parameters of reporting standards for the treatment of intact (iAAA) and ruptured (rAAA) abdominal aortic aneurysms are presented. The parameters serve as indicators of treatment quality. Material and methods: Systematic literature search in PubMed under the keywords "abdominal aortic aneurysm AND diameter threshold"/"abdominal aortic aneurysm AND outcome"/"abdominal aortic aneurysm AND mortality". Results: For iAAA repair, the aneurysm diameter represents the essential indicator for the quality of the indications. Perioperative complications and hospital mortality are adequately documented in most registries. In addition, for the evaluation of the quality of the operative procedure (endovascular repair, EVAR or open repair, OAR) overall mortality, aneurysm-related mortality, reintervention rate, rupture rate and quality of life have to be determined in the longer term. The case numbers of the treating institutions should also be given in order to be able to answer the question of minimum hospital volumes. The presentation of hospital mortality and postoperative complications can also be found in all major registries as quality parameters in rAAA; however, definitions of rupture and urgency of the procedure are often deficient. Information on the period between the onset of symptoms and patient admission to the treating facility, on the time from admission to the treating hospital to the start of treatment (incision) and on the number of patients admitted but no longer operatively or interventionally treated is indispensable for a sufficient register quality. The documentation of the lowest blood pressure before intubation and the state of consciousness of the patient is also indispensable in rAAA patients. Conclusions: The quality parameters presented in this article should also be consistently recorded and evaluated in the AAA register of the German Institute for Vascular Health Research (DIGG) of the German Society for Vascular Surgery and Vascular Medicine (DGG) in order to be able to make a clearer statement than before, especially for the care of rAAA.