Reconsidering gender relative to risk of rupture in the contemporary management of abdominal aortic aneurysms
Reconsidering gender relative to risk of rupture in the contemporary management of abdominal aortic aneurysms
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DOI：
10.1016/j.jvs.2015.07.079
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发表时间：
2015-12-01
影响因子：
4.3
通讯作者：
Rush, Daniel S.
中科院分区：
文献类型：
--
作者：
Skibba, Afshin A.;Evans, James R.;Rush, Daniel S.
目的：女性腹主动脉瘤（AAA）破裂的直径可能小于男性，由于年龄和合并症，女性在择期和紧急干预中的风险可能更高，结局更差。实践指南建议选择性AAA修复>5.5 cm是性别中立的，可能无法充分反映女性风险增加或选择性低风险血管内手术的潜在优势。方法：回顾性分析14年期间从单一转诊医院出院的AAA诊断患者。结果：共研究了2121例AAA患者，499例女性（23.5%）和1622例男性（76.5%）。女性年龄较大，高血压、吸烟、慢性阻塞性肺疾病、血脂异常和肾功能不全的发病率较高。467例女性完整AAA的平均直径为4.4 ± 1.3 cm，1538例男性为5.0 ± 1.4 cm（P
Objective: Abdominal aortic aneurysms (AAAs) may rupture at smaller diameters in women than in men, and women may be at higher risk and have poorer outcomes in elective and emergent interventions because of age and comorbidities. Practice guidelines recommending elective AAA repair at >5.5 cm are gender neutral and may not adequately reflect increased risks in women or the potential advantages of elective lower risk endovascular procedures.Methods: Patients with a diagnosis of AAA discharged from a single referral hospital during a 14-year period were identified for retrospective analysis.Results: A total of 2121 patients with AAAs were studied, 499 women (23.5%) and 1622 men (76.5%). Women were older and had a greater incidence of hypertension, smoking, chronic obstructive pulmonary disease, dyslipidemia, and renal insufficiency. Intact AAAs in 467 women had a mean diameter of 4.4 +/- 1.3 cm compared with 1538 men at 5.0 +/- 1.4 cm (P