Cargando…

Gender-Based Differences in Abdominal Aortic Aneurysm Rupture: A Retrospective Study

BACKGROUND: Annually, 5% of sudden deaths are due to abdominal aortic aneurysm (AAA) rupture. There is evidence suggesting that AAA ruptures have worse outcomes in females than males and the aneurysms rupture at a smaller size in females than in males. The United States Preventive Services Task Forc...

Descripción completa

Detalles Bibliográficos
Autores principales: Malayala, Srikrishna Varun, Raza, Ambreen, Vanaparthy, Rachana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7781278/
https://www.ncbi.nlm.nih.gov/pubmed/33447313
http://dx.doi.org/10.14740/jocmr4376
_version_ 1783631646359027712
author Malayala, Srikrishna Varun
Raza, Ambreen
Vanaparthy, Rachana
author_facet Malayala, Srikrishna Varun
Raza, Ambreen
Vanaparthy, Rachana
author_sort Malayala, Srikrishna Varun
collection PubMed
description BACKGROUND: Annually, 5% of sudden deaths are due to abdominal aortic aneurysm (AAA) rupture. There is evidence suggesting that AAA ruptures have worse outcomes in females than males and the aneurysms rupture at a smaller size in females than in males. The United States Preventive Services Task Force (USPSTF) recommends a one-time ultrasound screening for males aged 65 - 75 years who ever smoked. There is insufficient evidence to screen females aged 65 - 75 years who ever smoked though there is evidence suggesting that AAAs rupture at a smaller size and have worse outcomes in females. The objective of this study is to compare the characteristics, mortality and morbidity of ruptured AAAs in females and males. METHODS: This is a retrospective review of 117 patients from two teaching institutions over a period of 6 years. A total of 39 parameters were compared between males and females including demographic variables, comorbidities like hypertension, dyslipidemia, cardiovascular diseases; previous history of AAA; medications, characteristics of aneurysm, type of surgery and its outcome; postoperative complications and long-term survival. RESULTS: The overall incidence of AAA rupture was higher in males (68%) than in females (32%). Females die from AAA rupture at a later age. There was a significant difference in the size of AAA rupture between females (mean = 7.4 cm, standard deviation (SD) = 2.0) and males (mean = 8.2 cm, SD = 1.8; P = 0.04). The probability to undergo surgery for ruptured AAA was significantly lower for females as compared to males (P = 0.03). Females had higher overall mortality (P = 0.001), postoperative mortality (P = 0.02), higher length of intensive care unit (ICU) stay, incidence of postoperative complications, use of vasopressors and use of ventilator. CONCLUSIONS: Using a similar threshold of size of AAA for elective surgery for both males and females might not be appropriate. Further population-based studies are needed to warrant AAA screening for high-risk females owing to the higher morbidity and mortality.
format Online
Article
Text
id pubmed-7781278
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Elmer Press
record_format MEDLINE/PubMed
spelling pubmed-77812782021-01-13 Gender-Based Differences in Abdominal Aortic Aneurysm Rupture: A Retrospective Study Malayala, Srikrishna Varun Raza, Ambreen Vanaparthy, Rachana J Clin Med Res Original Article BACKGROUND: Annually, 5% of sudden deaths are due to abdominal aortic aneurysm (AAA) rupture. There is evidence suggesting that AAA ruptures have worse outcomes in females than males and the aneurysms rupture at a smaller size in females than in males. The United States Preventive Services Task Force (USPSTF) recommends a one-time ultrasound screening for males aged 65 - 75 years who ever smoked. There is insufficient evidence to screen females aged 65 - 75 years who ever smoked though there is evidence suggesting that AAAs rupture at a smaller size and have worse outcomes in females. The objective of this study is to compare the characteristics, mortality and morbidity of ruptured AAAs in females and males. METHODS: This is a retrospective review of 117 patients from two teaching institutions over a period of 6 years. A total of 39 parameters were compared between males and females including demographic variables, comorbidities like hypertension, dyslipidemia, cardiovascular diseases; previous history of AAA; medications, characteristics of aneurysm, type of surgery and its outcome; postoperative complications and long-term survival. RESULTS: The overall incidence of AAA rupture was higher in males (68%) than in females (32%). Females die from AAA rupture at a later age. There was a significant difference in the size of AAA rupture between females (mean = 7.4 cm, standard deviation (SD) = 2.0) and males (mean = 8.2 cm, SD = 1.8; P = 0.04). The probability to undergo surgery for ruptured AAA was significantly lower for females as compared to males (P = 0.03). Females had higher overall mortality (P = 0.001), postoperative mortality (P = 0.02), higher length of intensive care unit (ICU) stay, incidence of postoperative complications, use of vasopressors and use of ventilator. CONCLUSIONS: Using a similar threshold of size of AAA for elective surgery for both males and females might not be appropriate. Further population-based studies are needed to warrant AAA screening for high-risk females owing to the higher morbidity and mortality. Elmer Press 2020-12 2020-12-18 /pmc/articles/PMC7781278/ /pubmed/33447313 http://dx.doi.org/10.14740/jocmr4376 Text en Copyright 2020, Malayala et al. http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Malayala, Srikrishna Varun
Raza, Ambreen
Vanaparthy, Rachana
Gender-Based Differences in Abdominal Aortic Aneurysm Rupture: A Retrospective Study
title Gender-Based Differences in Abdominal Aortic Aneurysm Rupture: A Retrospective Study
title_full Gender-Based Differences in Abdominal Aortic Aneurysm Rupture: A Retrospective Study
title_fullStr Gender-Based Differences in Abdominal Aortic Aneurysm Rupture: A Retrospective Study
title_full_unstemmed Gender-Based Differences in Abdominal Aortic Aneurysm Rupture: A Retrospective Study
title_short Gender-Based Differences in Abdominal Aortic Aneurysm Rupture: A Retrospective Study
title_sort gender-based differences in abdominal aortic aneurysm rupture: a retrospective study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7781278/
https://www.ncbi.nlm.nih.gov/pubmed/33447313
http://dx.doi.org/10.14740/jocmr4376
work_keys_str_mv AT malayalasrikrishnavarun genderbaseddifferencesinabdominalaorticaneurysmrupturearetrospectivestudy
AT razaambreen genderbaseddifferencesinabdominalaorticaneurysmrupturearetrospectivestudy
AT vanaparthyrachana genderbaseddifferencesinabdominalaorticaneurysmrupturearetrospectivestudy