Trends in Thoracic Aortic Aneurysm Hospital Admissions, Interventions, and Mortality in England between 1998 and 2020: An Observational Study

Hanna, Lydia; Sounderajah, Viknesh; Abdullah, Ammar; Marshall, Dominic C; Salciccioli, Justin D.; Shalhoub, Joseph; Gibbs, Richard

doi:10.1016/j.ejvs.2022.07.003

Cited by 4 publications

(1 citation statement)

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“…As hospital admissions for AAA have decreased, the operative intervention for AAA has also declined due to the reduction in open aortic repair despite the increase in EVAR utilisation. Similar operative trends have also been observed in the UK National Vascular Registry and in the Swedish Vascular Registry [ 20 , 21 ]. These trends could be explained by the substantial changes that have influenced AAA management over the last two decades including the establishment of EVAR, the implementation of cardiovascular risk factor management, the introduction of statins and increased public health awareness on the importance of lowering blood pressure and smoking cessation.…”

Section: Discussionsupporting

confidence: 78%

Incidence and Outcomes of Abdominal Aortic Aneurysm Repair in New Zealand from 2001 to 2021

Gormley

Bernau

et al. 2023

JCM

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Purpose: The burden of abdominal aortic aneurysms (AAA) has changed in the last 20 years but is still considered to be a major cause of cardiovascular mortality. The introduction of endovascular aortic repair (EVAR) and improved peri-operative care has resulted in a steady improvement in both outcomes and long-term survival. The objective of this study was to identify the burden of AAA disease by analysing AAA-related hospitalisations and deaths. Methodology: All AAA-related hospitalisations in NZ from January 2001 to December 2021 were identified from the National Minimum Dataset, and mortality data were obtained from the NZ Mortality Collection dataset from January 2001 to December 2018. Data was analysed for patient characteristics including deprivation index, repair methods and 30-day outcomes. Results: From 2001 to 2021, 14,436 patients with an intact AAA were identified with a mean age of 75.1 years (SD 9.7 years), and 4100 (28%) were females. From 2001 to 2018, there were 5000 ruptured AAA with a mean age of 77.8 (SD 9.4), and 1676 (33%) were females. The rate of hospitalisations related to AAA has decreased from 43.7 per 100,000 in 2001 to 15.4 per 100,000 in 2018. There was a higher proportion of rupture AAA in patients living in more deprived areas. The use of EVAR for intact AAA repair has increased from 18.1% in 2001 to 64.3% in 2021. The proportion of octogenarians undergoing intact AAA repair has increased from 16.2% in 2001 to 28.4% in 2021. The 30-day mortality for intact AAA repair has declined from 5.8% in 2001 to 1.7% in 2021; however, it has remained unchanged for ruptured AAA repair at 31.6% across the same period. Conclusions: This study highlights that the incidence of AAA has declined in the last two decades. The mortality has improved for patients who had a planned repair. Understanding the contemporary burden of AAA is paramount to improve access to health, reduce variation in outcomes and promote surgical quality improvement.

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Section: Discussionsupporting

confidence: 78%