Differences between women and men in surgical treatment and case fatality rates for ruptured aortic abdominal aneurysm in England
Open Access
- 18 May 2007
- journal article
- research article
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 94 (9), 1096-1099
- https://doi.org/10.1002/bjs.5784
Abstract
Background: Differences between women and men in treatment and outcome after admission with a ruptured abdominal aortic aneurysm (AAA) in England were studied. Methods: Routinely collected data in Hospital Episode Statistics, linked to death records, for emergency admissions for ruptured AAA in England were analysed. The percentage of patients who underwent surgical repair was calculated, together with 30-day case fatality rates and age-adjusted odds ratios (ORs), comparing women with men. Results: A total of 2463 women and 7615 men were admitted with a primary diagnosis of ruptured AAA (mean age 79·8 and 74·9 years respectively); 39·6 per cent of women and 66·4 per cent of men underwent surgical repair (OR 0·47 (95 per cent confidence interval 0·42 to 0·52)). Overall, 75·6 per cent of women and 61·7 per cent of men died within 30 days of admission (OR 1·36 (1·22 to 1·52)). The death rate for women and men who had surgery was similar (OR 1·01 (0·88 to 1·17)); when no operation was performed the mortality rate was higher in women, but not significantly so (OR 1·14 (0·91 to 1·42)). Conclusion: Women with a ruptured AAA were less likely to be treated surgically than men, and their overall mortality rate was higher. Lower rates of surgery in women than in men may contribute to the higher mortality in women, but other explanations are possible.Keywords
Funding Information
- NHS National Centre for Research Capacity Development
- Department of Anaesthesia, University Hospital Basle, Switzerland
This publication has 8 references indexed in Scilit:
- ACC/AHA 2005 Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic): A Collaborative Report from the American Association for Vascular Surgery/Society for Vascular Surgery,Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease)Journal of the American College of Cardiology, 2006
- Trends in mortality and hospital admission rates for abdominal aortic aneurysm in England and Wales, 1979–1999British Journal of Surgery, 2005
- Predictors of repair and effect of gender on treatment of ruptured abdominal aortic aneurysmJournal of Vascular Surgery, 2004
- Epidemiology and Outcome of Aortic Aneurysms in Hong KongWorld Journal of Surgery, 2003
- The influence of gender on outcome after ruptured abdominal aortic aneurysmJournal of Vascular Surgery, 2000
- Relation of Race and Sex to the Use of Reperfusion Therapy in Medicare Beneficiaries with Acute Myocardial InfarctionNew England Journal of Medicine, 2000
- Influence of gender on outcome from ruptured abdominal aortic aneurysmBritish Journal of Surgery, 2000
- Gender differences in abdominal aortic aneurysm prevalence, treatment, and outcomeJournal of Vascular Surgery, 1997