Thresholds for Abdominal Aortic Aneurysm Repair in England and the United States
Autor: | Alberto Vidal-Diez, Bruce E. Landon, Peter A. Soden, Alan Karthikesalingam, Marc L. Schermerhorn, Peter J. Holt, Ian M. Loftus, Matt M. Thompson |
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Rok vydání: | 2016 |
Předmět: |
Male
medicine.medical_specialty Aortic Rupture Kaplan-Meier Estimate 030204 cardiovascular system & hematology Aneurysm rupture 03 medical and health sciences Aortic aneurysm 0302 clinical medicine Aneurysm Risk Factors medicine.artery medicine Humans Aorta Abdominal cardiovascular diseases 030212 general & internal medicine Aortic rupture Aorta business.industry Incidence Incidence (epidemiology) General Medicine medicine.disease United States Abdominal aortic aneurysm 3. Good health Surgery Hospitalization Logistic Models England cardiovascular system Female Radiology business Aortic Aneurysm Abdominal Abdominal surgery |
Zdroj: | New England Journal of Medicine. 375:2051-2059 |
ISSN: | 1533-4406 0028-4793 |
Popis: | Background Thresholds for repair of abdominal aortic aneurysms vary considerably among countries. Methods We examined differences between England and the United States in the frequency of aneurysm repair, the mean aneurysm diameter at the time of the procedure, and rates of aneurysm rupture and aneurysm-related death. Data on the frequency of repair of intact (nonruptured) abdominal aortic aneurysms, in-hospital mortality among patients who had undergone aneurysm repair, and rates of aneurysm rupture during the period from 2005 through 2012 were extracted from the Hospital Episode Statistics database in England and the U.S. Nationwide Inpatient Sample. Data on the aneurysm diameter at the time of repair were extracted from the U.K. National Vascular Registry (2014 data) and from the U.S. National Surgical Quality Improvement Program (2013 data). Aneurysm-related mortality during the period from 2005 through 2012 was determined from data obtained from the Centers for Disease Control and Prevention and the U.K. Office of National Statistics. Data were adjusted with the use of direct standardization or conditional logistic regression for differences between England and the United States with respect to population age and sex. Results During the period from 2005 through 2012, a total of 29,300 patients in England and 278,921 patients in the United States underwent repair of intact abdominal aortic aneurysms. Aneurysm repair was less common in England than in the United States (odds ratio, 0.49; 95% confidence interval [CI], 0.48 to 0.49; P |
Databáze: | OpenAIRE |
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