Changing Epidemiology of Abdominal Aortic Aneurysms in England and Wales: Older and More Benign?
Recent studies from Australia, New Zealand, and Sweden have reported declines in abdominal aortic aneurysm (AAA) incidence, prevalence, and mortality. This finding may have important implications for screening programs. This study determined trends in AAA incidence and mortality in England and Wales...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 2012-04, Vol.125 (13), p.1617-1625 |
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| container_title | Circulation (New York, N.Y.) |
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| creator | CHOKE, Edward VIJAYNAGAR, Badri THOMPSON, John NASIM, Akhtar BOWN, Matthew J SAYERS, Robert D |
| description | Recent studies from Australia, New Zealand, and Sweden have reported declines in abdominal aortic aneurysm (AAA) incidence, prevalence, and mortality. This finding may have important implications for screening programs. This study determined trends in AAA incidence and mortality in England and Wales.
Cause-specific mortality data for England and Wales were obtained from UK Office for National Statistics, and hospital admissions and procedures data for England were obtained from Hospital Episode Statistics from 2001 to 2009. Poisson regression models were constructed to estimate the relative change over time. Age-standardized rates for AAA mortality in England and Wales fell significantly by 35.7% from 2001 to 2009, which was largely due to a 35.3% drop in age-standardized ruptured AAA deaths. During the same period, ruptured AAA admissions and emergency AAA repairs in England declined by 29.3% and 35.5%, respectively. In contrast, nonruptured AAA admissions remained static, and nonemergency AAA repairs increased by 17.2%. The average ages for hospital admissions for nonruptured AAAs and ruptured AAAs increased by 0.19 years of age per annum (P |
| doi_str_mv | 10.1161/CIRCULATIONAHA.111.077503 |
| format | Article |
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Cause-specific mortality data for England and Wales were obtained from UK Office for National Statistics, and hospital admissions and procedures data for England were obtained from Hospital Episode Statistics from 2001 to 2009. Poisson regression models were constructed to estimate the relative change over time. Age-standardized rates for AAA mortality in England and Wales fell significantly by 35.7% from 2001 to 2009, which was largely due to a 35.3% drop in age-standardized ruptured AAA deaths. During the same period, ruptured AAA admissions and emergency AAA repairs in England declined by 29.3% and 35.5%, respectively. In contrast, nonruptured AAA admissions remained static, and nonemergency AAA repairs increased by 17.2%. The average ages for hospital admissions for nonruptured AAAs and ruptured AAAs increased by 0.19 years of age per annum (P<0.001) and 0.09 years of age per annum (P<0.001), respectively. Nonruptured AAA admissions increased by 21.4% in age band 75 years or more but declined by 11.7% in ages <75 years.
AAA mortality, ruptured AAA admission, and emergency AAA repair have declined in England and Wales. However, nonruptured AAA admission has remained steady, with an increasing rate in older population offsetting a decreasing rate in younger population. This suggests a shift in AAA presentation to the older population. Present screening strategies may need reassessment to include consideration for increasing the age at which to screen men for AAAs.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/CIRCULATIONAHA.111.077503</identifier><identifier>PMID: 22361325</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Age Factors ; Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal - epidemiology ; Aortic Aneurysm, Abdominal - mortality ; Aortic Aneurysm, Abdominal - pathology ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Cohort Studies ; Diseases of the aorta ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; England - epidemiology ; Female ; Humans ; Male ; Medical sciences ; Patient Admission - trends ; Wales - epidemiology</subject><ispartof>Circulation (New York, N.Y.), 2012-04, Vol.125 (13), p.1617-1625</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c290t-16fdc607b024d25a4d4f272a93b2cc34d9e343f82b6040c5a99025d0c3b3d7fd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,3688,27929,27930</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25756067$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22361325$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CHOKE, Edward</creatorcontrib><creatorcontrib>VIJAYNAGAR, Badri</creatorcontrib><creatorcontrib>THOMPSON, John</creatorcontrib><creatorcontrib>NASIM, Akhtar</creatorcontrib><creatorcontrib>BOWN, Matthew J</creatorcontrib><creatorcontrib>SAYERS, Robert D</creatorcontrib><title>Changing Epidemiology of Abdominal Aortic Aneurysms in England and Wales: Older and More Benign?</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>Recent studies from Australia, New Zealand, and Sweden have reported declines in abdominal aortic aneurysm (AAA) incidence, prevalence, and mortality. This finding may have important implications for screening programs. This study determined trends in AAA incidence and mortality in England and Wales.
Cause-specific mortality data for England and Wales were obtained from UK Office for National Statistics, and hospital admissions and procedures data for England were obtained from Hospital Episode Statistics from 2001 to 2009. Poisson regression models were constructed to estimate the relative change over time. Age-standardized rates for AAA mortality in England and Wales fell significantly by 35.7% from 2001 to 2009, which was largely due to a 35.3% drop in age-standardized ruptured AAA deaths. During the same period, ruptured AAA admissions and emergency AAA repairs in England declined by 29.3% and 35.5%, respectively. In contrast, nonruptured AAA admissions remained static, and nonemergency AAA repairs increased by 17.2%. The average ages for hospital admissions for nonruptured AAAs and ruptured AAAs increased by 0.19 years of age per annum (P<0.001) and 0.09 years of age per annum (P<0.001), respectively. Nonruptured AAA admissions increased by 21.4% in age band 75 years or more but declined by 11.7% in ages <75 years.
AAA mortality, ruptured AAA admission, and emergency AAA repair have declined in England and Wales. However, nonruptured AAA admission has remained steady, with an increasing rate in older population offsetting a decreasing rate in younger population. This suggests a shift in AAA presentation to the older population. Present screening strategies may need reassessment to include consideration for increasing the age at which to screen men for AAAs.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aortic Aneurysm, Abdominal - epidemiology</subject><subject>Aortic Aneurysm, Abdominal - mortality</subject><subject>Aortic Aneurysm, Abdominal - pathology</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Cohort Studies</subject><subject>Diseases of the aorta</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>England - epidemiology</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Patient Admission - trends</subject><subject>Wales - epidemiology</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkE9PGzEQxa0KRALlK1TuAfW04D9rO-aCtqu0iRQaCSXiuPXa3q2rXTvYySHfnk2TgjiMRvP0ezOjB8BXjG4x5viunD-V60Wxmi9_FbNi0PAtEoIh-gmMMSN5ljMqz8AYISQzQQkZgcuU_g4jp4JdgBEhlGNK2Bj8Lv8o3zrfwunGGdu70IV2D0MDi9qE3nnVwSLErdOw8HYX96lP0Hk49W2nvIGHeladTfdw2Rkb_wmPIVr43XrX-ofP4LxRXbLXp34F1j-mq3KWLZY_52WxyDSRaJth3hjNkagRyQ1hKjd5QwRRktZEa5obaWlOmwmpOcqRZkpKRJhBmtbUiMbQK_DtuHcTw8vOpm3Vu6RtN3xpwy5Vkk8w4kzygZRHUseQUrRNtYmuV3FfYVQd8q0-5jtouDrmO3i_nK7s6t6aN-f_QAfg5gSopFXXROW1S-8cE4wjLugrFkqEJg</recordid><startdate>20120403</startdate><enddate>20120403</enddate><creator>CHOKE, Edward</creator><creator>VIJAYNAGAR, Badri</creator><creator>THOMPSON, John</creator><creator>NASIM, Akhtar</creator><creator>BOWN, Matthew J</creator><creator>SAYERS, Robert D</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120403</creationdate><title>Changing Epidemiology of Abdominal Aortic Aneurysms in England and Wales: Older and More Benign?</title><author>CHOKE, Edward ; VIJAYNAGAR, Badri ; THOMPSON, John ; NASIM, Akhtar ; BOWN, Matthew J ; SAYERS, Robert D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c290t-16fdc607b024d25a4d4f272a93b2cc34d9e343f82b6040c5a99025d0c3b3d7fd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aortic Aneurysm, Abdominal - epidemiology</topic><topic>Aortic Aneurysm, Abdominal - mortality</topic><topic>Aortic Aneurysm, Abdominal - pathology</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Cohort Studies</topic><topic>Diseases of the aorta</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>England - epidemiology</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Patient Admission - trends</topic><topic>Wales - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CHOKE, Edward</creatorcontrib><creatorcontrib>VIJAYNAGAR, Badri</creatorcontrib><creatorcontrib>THOMPSON, John</creatorcontrib><creatorcontrib>NASIM, Akhtar</creatorcontrib><creatorcontrib>BOWN, Matthew J</creatorcontrib><creatorcontrib>SAYERS, Robert D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>CHOKE, Edward</au><au>VIJAYNAGAR, Badri</au><au>THOMPSON, John</au><au>NASIM, Akhtar</au><au>BOWN, Matthew J</au><au>SAYERS, Robert D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changing Epidemiology of Abdominal Aortic Aneurysms in England and Wales: Older and More Benign?</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2012-04-03</date><risdate>2012</risdate><volume>125</volume><issue>13</issue><spage>1617</spage><epage>1625</epage><pages>1617-1625</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>Recent studies from Australia, New Zealand, and Sweden have reported declines in abdominal aortic aneurysm (AAA) incidence, prevalence, and mortality. This finding may have important implications for screening programs. This study determined trends in AAA incidence and mortality in England and Wales.
Cause-specific mortality data for England and Wales were obtained from UK Office for National Statistics, and hospital admissions and procedures data for England were obtained from Hospital Episode Statistics from 2001 to 2009. Poisson regression models were constructed to estimate the relative change over time. Age-standardized rates for AAA mortality in England and Wales fell significantly by 35.7% from 2001 to 2009, which was largely due to a 35.3% drop in age-standardized ruptured AAA deaths. During the same period, ruptured AAA admissions and emergency AAA repairs in England declined by 29.3% and 35.5%, respectively. In contrast, nonruptured AAA admissions remained static, and nonemergency AAA repairs increased by 17.2%. The average ages for hospital admissions for nonruptured AAAs and ruptured AAAs increased by 0.19 years of age per annum (P<0.001) and 0.09 years of age per annum (P<0.001), respectively. Nonruptured AAA admissions increased by 21.4% in age band 75 years or more but declined by 11.7% in ages <75 years.
AAA mortality, ruptured AAA admission, and emergency AAA repair have declined in England and Wales. However, nonruptured AAA admission has remained steady, with an increasing rate in older population offsetting a decreasing rate in younger population. This suggests a shift in AAA presentation to the older population. Present screening strategies may need reassessment to include consideration for increasing the age at which to screen men for AAAs.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>22361325</pmid><doi>10.1161/CIRCULATIONAHA.111.077503</doi><tpages>9</tpages></addata></record> |
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| ispartof | Circulation (New York, N.Y.), 2012-04, Vol.125 (13), p.1617-1625 |
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| source | MEDLINE; American Heart Association Journals; EZB-FREE-00999 freely available EZB journals; Journals@Ovid Complete |
| subjects | Age Factors Aged Aged, 80 and over Aortic Aneurysm, Abdominal - epidemiology Aortic Aneurysm, Abdominal - mortality Aortic Aneurysm, Abdominal - pathology Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Cohort Studies Diseases of the aorta Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous England - epidemiology Female Humans Male Medical sciences Patient Admission - trends Wales - epidemiology |
| title | Changing Epidemiology of Abdominal Aortic Aneurysms in England and Wales: Older and More Benign? |
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