This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Influence of sex on the outcome of ruptured abdominal aortic aneurysm. BJS 2000; 87: 499-499.
Published: 6th December 2002
Authors: P. Norman
Background
Mortality rates from ruptured abdominal aortic aneurysm (AAA) in men and women were compared.
Method
Patients were identified from a population‐based database using the relevant ICD‐9‐CM codes and were divided into three groups for analysis: those dying without admission to hospital, those admitted to hospital with ruptured AAA but not undergoing surgery, and those who underwent surgery for ruptured AAA.
Results
Ruptured AAA occurred in 648 men and 225 women over the age of 55 years during the decade 1985–1994. The proportion of women increased with age from 13·8 per cent for those aged 60–69 years, to 42·3 per cent for those over 80 years of age. Only 49·7 per cent of women (112 of 225), compared with 58·9 per cent of men (382 of 648), with ruptured AAA were admitted to hospital (χ2 = 5·35, P = 0·02). Of those admitted to hospital, only 36·6 per cent of women (41 of 112) underwent surgery compared with 63·3 per cent of men (242 of 382) (χ2 = 8·71, P = 0·003). The mortality rate in women undergoing surgery was 44 per cent (18 of 41) compared with 34·7 per cent (84 of 242) in men (χ2 = 5·35, P = 0·021). The overall mortality rate from ruptured AAA was 89·8 per cent in women (202 of 225) and 75·6 per cent in men (490 of 648) (χ2 = 50·34, P < 0·0001). Although women were on average older than men, age‐specific analysis showed that this unfavourable pattern occurred in all age groups.
Conclusion
Women with ruptured AAA are more likely to die than men. The cause of the poor outcome in women is unclear but may be due to the use of thresholds for intervention that are based on aortic diameters in men. © 2000 British Journal of Surgery Society Ltd
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