PMID- 18771883
OWN - NLM
STAT- MEDLINE
DCOM- 20081113
LR  - 20220408
IS  - 1097-6809 (Electronic)
IS  - 0741-5214 (Linking)
VI  - 48
IP  - 5
DP  - 2008 Nov
TI  - National trends in the repair of ruptured abdominal aortic aneurysms.
PG  - 1101-7
LID - 10.1016/j.jvs.2008.06.031 [doi]
AB  - OBJECTIVE: This study evaluated trends in hospitalizations, treatment, and 
      mortality of ruptured abdominal aortic aneurysms (rAAAs) in the United States 
      Medicare population. METHODS: The Medicare inpatient database (1995 through 2006) 
      was reviewed for patients with rAAA and AAA by using International Classification 
      of Disease (9th Clinical Modification) codes for rAAA and AAA. Proportions and 
      trends were analyzed by chi(2) analysis, continuous variables by t test, and 
      trends by the Cochran-Armitage test. RESULTS: During the study period, 
      hospitalizations with the diagnoses of rAAA declined from 23.2 to 12.8 per 
      100,000 Medicare beneficiaries (P < .0001), as did repairs of rAAA (15.6 to 8.4 
      per 100,000; P < .0001). No change was observed in AAA elective repairs. The 
      30-day mortality rate after open repair of rAAA decreased by 4.9% (from 39.6% to 
      34.7%; P = .0007 for trend) for the age group 65 to 74 and by 2.4% (from 52.9% to 
      50.5%, P = .0008) for the age group > or =75. Perioperative mortality after 
      endovascular repair diminished by 13.6% (from 43.5% in 2001 to 29.9% in 2006; P = 
      .0020). Mortality among women was higher than among men (51.1% vs 40.0% in 2006). 
      The demographics of patients treated for rAAA changed to include a greater 
      proportion of women and patients aged > or =75 years. CONCLUSION: A significant 
      decrease has occurred in the number of patients who have a diagnosis of rAAA and 
      undergo treatment, but there has been no change in repairs of AAA. The 
      perioperative mortality rate has improved due to the introduction of endovascular 
      repair and a small but progressive improvement in survival after open repair for 
      patients aged 65 to 74 years.
FAU - Mureebe, Leila
AU  - Mureebe L
AD  - Division of Vascular Surgery, New York Presbyterian Hospital, Columbia College of 
      Physicians and Surgeons, Weill Medical College of Cornell University, New York, 
      NY 10032, USA.
FAU - Egorova, Natalia
AU  - Egorova N
FAU - Giacovelli, Jeannine K
AU  - Giacovelli JK
FAU - Gelijns, Annetine
AU  - Gelijns A
FAU - Kent, K Craig
AU  - Kent KC
FAU - McKinsey, James F
AU  - McKinsey JF
LA  - eng
PT  - Journal Article
DEP - 20080904
PL  - United States
TA  - J Vasc Surg
JT  - Journal of vascular surgery
JID - 8407742
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aortic Aneurysm, Abdominal/mortality/*surgery
MH  - Aortic Rupture/mortality/*surgery
MH  - Female
MH  - Hospitalization/*trends
MH  - Humans
MH  - Male
MH  - Medicare/statistics & numerical data
MH  - Sex Factors
MH  - Time Factors
MH  - Treatment Outcome
MH  - United States/epidemiology
MH  - Vascular Surgical Procedures/mortality/*trends
EDAT- 2008/09/06 09:00
MHDA- 2008/11/14 09:00
CRDT- 2008/09/06 09:00
PHST- 2008/01/02 00:00 [received]
PHST- 2008/06/10 00:00 [revised]
PHST- 2008/06/16 00:00 [accepted]
PHST- 2008/09/06 09:00 [pubmed]
PHST- 2008/11/14 09:00 [medline]
PHST- 2008/09/06 09:00 [entrez]
AID - S0741-5214(08)01024-0 [pii]
AID - 10.1016/j.jvs.2008.06.031 [doi]
PST - ppublish
SO  - J Vasc Surg. 2008 Nov;48(5):1101-7. doi: 10.1016/j.jvs.2008.06.031. Epub 2008 Sep 
      4.