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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...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elmer Press
2020
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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 |
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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 |
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