Document Detail


Regional disparities in incidence, handling and outcomes of patients with symptomatic and ruptured abdominal aortic aneurysms in Norway.
MedLine Citation:
PMID:  22658615     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To study incidence, handling and outcome of patients hospitalised with symptomatic and ruptured abdominal aortic aneurysm in Norway. DESIGN, MATERIAL AND METHODS: Retrospective study of 1291 patients, between January 2008 and August 2010 using the National Patient Registry and a regional vascular surgery registry. We applied a stepwise logistic regression model to detect differences in regional in-hospital mortality.
RESULTS: 385/711 (54%) patients hospitalised for aneurysm rupture, rAAA (ICD-10: I71.3), died. The odds of dying varied with a factor 2.3 between the extreme regions. 475/711 (67%) underwent repair, 323 survived, giving an in-hospital mortality rate of 32% after surgery. Older patients were significantly less likely to be transported for surgery. The overall incidence for patients aged >50 was 16.6 rAAA per 100,000 person-years. There was remarkable variation across counties with rates between 7.7 and 26.8. A total of 580 patients were hospitalised with suspected symptomatic aneurysms (ICD-10:I71.4, acute admission); 224 (39%) were treated with aneurysm repair, 356 (61%) were discharged without repair without a significant difference across health regions.
CONCLUSIONS: For rAAA, we found substantial geographical variations in incidence, surgery and patient outcome. These results highlight the need for increased awareness about the condition and suggest ways to improve care trajectories to reduce delay to surgery, thereby minimising rupture mortality.
Authors:
B J Brattheim; T A Eikemo; M Altreuther; A D Landmark; A Faxvaag
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-05-31
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  44     ISSN:  1532-2165     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-24     Completed Date:  2012-11-02     Revised Date:  2013-02-28    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  267-72     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Department of Radiography, Sør-Trøndelag University College (HiST), Trondheim, Norway. berit.j.brattheim@ntnu.no
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal / mortality,  surgery*
Aortic Rupture / mortality,  surgery*
Chi-Square Distribution
Delivery of Health Care / statistics & numerical data*
Female
Healthcare Disparities / statistics & numerical data*
Hospital Mortality
Humans
Incidence
Inpatients / statistics & numerical data
Logistic Models
Male
Middle Aged
Norway / epidemiology
Odds Ratio
Patient Discharge / statistics & numerical data
Physician's Practice Patterns / statistics & numerical data*
Registries
Residence Characteristics / statistics & numerical data*
Retrospective Studies
Risk Assessment
Risk Factors
Survival Analysis
Time Factors
Treatment Outcome
Vascular Surgical Procedures / adverse effects,  mortality,  statistics & numerical data*
Comments/Corrections
Comment In:
Eur J Vasc Endovasc Surg. 2013 Jan;45(1):100-1   [PMID:  23182518 ]
Eur J Vasc Endovasc Surg. 2013 Jan;45(1):101-2   [PMID:  23200608 ]
Eur J Vasc Endovasc Surg. 2012 Sep;44(3):273   [PMID:  22818803 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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