Sex-Based Disparities in Outcomes With Abdominal Aortic Aneurysms.

Autor: Sciria CT; Department of Medicine, Division of Cardiology, Weill Cornell Cardiovascular Outcomes Research Group (CORG), New York, New York. Electronic address: chs9256@nyp.org., Osorio B; Weill Cornell Department of Internal Medicine, New York, New York., Wang J; Department of Medicine, Division of Cardiology, Weill Cornell Cardiovascular Outcomes Research Group (CORG), New York, New York., Lu DY; Department of Medicine, Division of Cardiology, Weill Cornell Cardiovascular Outcomes Research Group (CORG), New York, New York., Amin N; Department of Medicine, Division of Cardiology, Weill Cornell Cardiovascular Outcomes Research Group (CORG), New York, New York; Weill Cornell Medicine Women's Heart Program, New York, New York., Vohra A; Department of Medicine, Division of Cardiology, Weill Cornell Cardiovascular Outcomes Research Group (CORG), New York, New York., Yeo I; Department of Medicine, Division of Cardiology, Weill Cornell Cardiovascular Outcomes Research Group (CORG), New York, New York; Division of Cardiology, Department of Medicine, New York-Presbyterian Queens, New York, New York., Feldman DN; Department of Medicine, Division of Cardiology, Weill Cornell Cardiovascular Outcomes Research Group (CORG), New York, New York., Cheung JW; Department of Medicine, Division of Cardiology, Weill Cornell Cardiovascular Outcomes Research Group (CORG), New York, New York., Narula N; Department of Medicine, Division of Cardiology, Weill Cornell Cardiovascular Outcomes Research Group (CORG), New York, New York., Wong SC; Department of Medicine, Division of Cardiology, Weill Cornell Cardiovascular Outcomes Research Group (CORG), New York, New York., Kim LK; Department of Medicine, Division of Cardiology, Weill Cornell Cardiovascular Outcomes Research Group (CORG), New York, New York.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2021 Sep 15; Vol. 155, pp. 135-148. Date of Electronic Publication: 2021 Jul 19.
DOI: 10.1016/j.amjcard.2021.06.023
Abstrakt: Although abdominal aortic aneurysms (AAA) are more common in men, women with AAA have increased morbidity and mortality. Additionally, there are discrepancies among professional society guidelines for AAA screening in women. In this retrospective study from the Nationwide Inpatient Sample (NIS) database from 2003 to 2014, we compared rates of AAA repair (rupture and elective) and AAA-related mortality in men vs. women to identify predictors of death among men and women with AAA. We divided the population into 1) AAA rupture 2) elective AAA repair. The main outcomes included temporal trends in AAA rupture, rupture-related death, AAA repair, in-hospital death, and predictors of AAA-related death. There were 570,253 discharge records for AAA admissions between 2003 and 2014, including 22.8% women and 77.2% men. Women had a higher proportion of rupture (18.4% vs 12.6%, p <0.01). A smaller proportion of women underwent endovascular aortic repair (EVAR) compared with men in the ruptured AAA (13.9% vs. 20.3%, p <0.01) and elective repair (55.7% vs. 67.4%, p <0.01) cohorts. Within the ruptured cohort, a higher proportion of women did not receive repair (46.4% vs. 26.1%, p <0.01). On multivariable analysis, female gender was a significant predictor of death with rupture (OR 1.39, 95% CI 1.16 to 1.66) and elective repair (OR 1.74, 95% CI 1.36 to 2.22), with both elective EVAR (OR 2.52, 95% CI 2.06 to 3.09) and elective open aortic repair (OAR; OR 1.50, 95% CI 1.33 to 1.68). Propensity score matching confirmed a higher risk of death in women in both the rupture (OR 1.19, 95% CI 1.09 to 1.30) and elective repair (OR 1.50, 95% CI 1.35 to 1.67) cohorts. In conclusion, AAA poses significant morbidity and mortality, especially in women. Women were more likely to die before repair with AAA rupture and female gender was an independent predictor of mortality in both the rupture and elective repair groups.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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