Outcome from abdominal aortic aneurysms in Scotland, 1991-2006

Background: This study assessed the impact of sex, presentation and treatment on outcome from abdominal aortic aneurysm (AAA) in Scotland. Methods: All patients admitted from January 1991 to December 2006 with a primary diagnosis of AAA were identified. Patients were stratified by age, sex, admission diagnosis (ruptured versus intact) and procedure performed (endovascular versus open repair). Multivariable logistic regression analysis was used to determine predictors of mortality. Results: Some 9779 men and 2927 women were admitted with a principal diagnosis of AAA. Women were significantly older than men (median (range) age 75 (35–97) versus 71 (17–96) years; P < 0·001). A higher proportion of women presented with a ruptured AAA (29·5 versus 27·5 per cent; P = 0·043). Age (odds ratio (OR) 2·52 (95 per cent confidence interval 2·36 to 2·74); P < 0·001), female sex (OR 1·63 (1·48 to 1·78); P < 0·001) and admission diagnosis (OR 10·49 (9·53 to 11·54); P < 0·001) were independent predictors of early death, whereas endovascular repair predicted survival (OR 0·67 (0·58 to 0·76); P < 0·001). Conclusion: Women presenting with an AAA were older and more likely to be admitted with a ruptured aneurysm. Female sex was an independent risk factor for death from AAA. Copyright © 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Worse for women