The impact of gender on presentation, therapy, and mortality of abdominal aortic aneurysm in the United States, 2001-2004
The impact of gender on presentation, therapy, and mortality of abdominal aortic aneurysm in the United States, 2001-2004
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DOI：
10.1016/j.jvs.2007.01.043
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发表时间：
2007-05-01
影响因子：
4.3
通讯作者：
Eslami, Mohammad H.
中科院分区：
文献类型：
--
作者：
McPhee, James T.;Hill, Joshua S.;Eslami, Mohammad H.
简介：腹主动脉瘤（AAA）的选择性修复可以降低患者的破裂风险，并比急诊修复显著降低住院死亡率。先前的研究表明，女性AAA破裂率高于男性，并且女性具有更高的相关住院死亡率。本研究旨在评估目前美国患者性别对AAA表现和治疗以及相关结局的影响程度。方法：使用了全国住院患者样本，以及相关的ICD-9代码，识别所有主要诊断为完整（iAAA）或破裂/夹层（rAAA）的患者出院2001年到2004年间的腹主动脉瘤单变量和多元Logistic回归分析的variables were performed.Results：一个估计的220,403 AAA患者出院确定在研究期间。37，016例（17%）患者出现rAAA。与男性相比，女性AAA破裂的比例更高（21% vs 16%;比值比[OR] 1.40，95%置信区间[CI]，1.27-1.54）。从2001年到2004年，破裂率没有显著变化（趋势P = 0.85）。对于AAA，女性的住院死亡率高于男性（OR 1.60; 95% CI，1.24-2.07）。与男性相比，女性iAAA患者的住院死亡率在两种血管内治疗中均较高（2.1% vs 0.83%，P
Introduction: The elective repair of abdominal aortic aneurysms (AAA) may decrease a patient's risk of rupture and confers a significantly lower in-hospital mortality rate than emergency repair. Previous works have shown that AAA rupture rates are higher in women compared to men, and that women have higher associated in-hospital mortality rates. This study was performed to evaluate, currently, to what extent patient gender influences presentation and treatment of AAA and the associated outcomes in the United States.Methods: The Nationwide Inpatient Sample was used, with pertinent ICD-9 codes, to identify all patient-discharges that occurred with the primary diagnosis of intact (iAAA) or ruptured/dissecting (rAAA) abdominal aortic aneurysms between the years 2001 and 2004. Univariate and multiple logistic regression analyses of variables were performed.Results: An estimated 220,403 AAA patient-discharges were identified during the study period. 37,016 (17%) patients presented with rAAA. A higher percentage of women with AAA presented with rupture compared to men (21% vs 16%; odds ratio [OR] 1.40, 95% confidence interval [CI], 1.27-1.54). This rupture rate did not significantly change from 2001 to 2004 (P = .85 for trend). For AAA, women had higher odds of in-hospital mortality than men (OR 1.60; 95% CI, 1.24-2.07). Compared to men, in-hospital mortality rates for women with iAAA were higher for both endovascular (2.1% vs 0.83%, P