Falling rates of hospitalization and mortality from abdominal aortic aneurysms in Australia
Falling rates of hospitalization and mortality from abdominal aortic aneurysms in Australia
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DOI：
10.1016/j.jvs.2010.08.087
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发表时间：
2011-02-01
影响因子：
4.3
通讯作者：
Semmens, James B.
中科院分区：
文献类型：
--
作者：
Norman, Paul E.;Spilsbury, Katrina;Semmens, James B.
背景资料：对1970年至2000年期间腹主动脉瘤（AAA）人群趋势的研究均表明AAA的发病率正在增加。目前尚不清楚这种增长是否仍在继续。我们假设AAAs的发病率已经开始下降，在Australia.Methods：估计1999年至2006年期间，AAAs的死亡率的标准化的国家趋势，并估计1999年至2008年期间AAAs的医院分离（死亡或出院）。Poisson回归模型被构建来估计随着时间推移的相对变化。结果：AAAs的年龄标准化死亡率男性每年平均下降6.0%（95%置信区间[CI]，4.7-7.3），女性下降2.9%（95% CI，1.0-4.7）。在调整年龄后，男性的住院分离率平均下降了2.3%。（95% CI，1.4-2.7），对于未破裂AAA，为5.9% AAA破裂患者和女性患者（95% CI，5.0-6.6）平均降低2.2%（95% CI，1.4-3.0），破裂AAA为5.1%（95% CI，3.7-6.5）。破裂与非破裂相比，AAA在女性中的比例高于男性。除了80岁及以上的非破裂AAA患者外，不同年龄段的出院率均呈下降趋势。结论：自1999年以来，澳大利亚AAA的出院率和死亡率均有所下降。这表明AAA的发生率确实下降了。虽然原因尚不清楚，但它对有关筛查的政策决定有影响。（J Vasc Surg 2011;53：274-7.）
Background: Studies of the population trends for abdominal aortic aneurysms (AAAs) in the period 1970 to 2000 all indicated that the incidence of AAAs was increasing. It is not known whether this increase has continued. We hypothesized that the incidence of AAAs has begun to fall in Australia.Methods: Age-standardized national trends in mortality from AAAs were estimated for the period 1999 to 2006, and hospital separations (deaths or discharges) for AAAs were estimated for the period 1999 to 2008. Poisson regression models were constructed to estimate the relative change over time.Results: The age-standardized mortality rate from AAAs fell by an average of 6.0% (95% confidence interval [CI], 4.7-7.3) per annum in men and 2.9% (95% CI, 1.0-4.7) in women. After adjusting for age, hospital separations for men decreased by an average of 2.3% (95% CI, 1.4-2.7) per annum for nonruptured AAAs, and 5.9% (95% CI, 5.0-6.6) for ruptured AAAs and for women decreased by an average of 2.2% (95% CI, 1.4-3.0) per annum for nonruptured AAAs, and 5.1% (95% CI, 3.7-6.5) for ruptured AAAs. Ruptured, compared with nonruptured, AAAs were proportionally more common in women compared with men. The age-specific trends in separations from hospital were all downward apart from nonruptured AAAs in individuals aged 80 years and over.Conclusions: The rates of separation from hospital and mortality for AAAs in Australia have fallen since 1999. This suggests a true fall in incidence of AAAs. Although the reasons for this are unknown, it has implications for policy decisions about screening. (J Vasc Surg 2011;53:274-7.)