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Aortic aneurysm at autopsy: a five year survey in Hong Kong
Insights
Aortic aneurysms occurred in 1 in 33 autopsies, primarily affecting older males. Rupture was the main cause of death, with most aneurysms undiagnosed before autopsy.
Area of Science:
- Cardiovascular Pathology
- Epidemiology
- Geriatric Medicine
Background:
- Aortic aneurysms are a significant cause of mortality.
- Understanding the epidemiology and risk factors is crucial for prevention and early detection.
Purpose of the Study:
- To determine the incidence and characteristics of aortic aneurysms in a Hong Kong population.
- To identify common causes of death and associated conditions in patients with aortic aneurysms.
Main Methods:
- Retrospective review of 3133 consecutive autopsies performed between 1986 and 1990.
- Analysis of autopsy findings for aortic aneurysms, including location, type, and cause of death.
- Correlation of aneurysm presence with patient demographics and comorbidities.
Main Results:
- 96 cases of aortic aneurysms were identified, an incidence of 1 in 33 autopsies.
- The disease was most prevalent in the eighth decade of life, with a male to female ratio of 1.8:1.
- Rupture (70%) and atherosclerotic diseases (14%) were the primary causes of death; 62% were unsuspected before autopsy.
- Infra-renal abdominal aorta was the most common site for non-dissecting aneurysms; Daily's type A was more common for dissecting aneurysms.
- Hypertension was frequently observed, along with other comorbidities such as ischemic heart disease and diabetes mellitus.
Conclusions:
- Aortic aneurysms are relatively common, particularly in elderly males, and often present asymptomatically.
- Rupture remains a major cause of mortality, highlighting the need for improved diagnostic strategies.
- Associated conditions like hypertension and atherosclerosis play a significant role in aneurysm development and complications.
Abstract:
The authors reviewed 3133 consecutive autopsies performed in the 5 year period from 1986 to 1990 in Queen Mary Hospital (Hong Kong), and 96 cases of aortic aneurysms were found. The incidence was 1 in 33 autopsies. The ratio of male to female was 1.8 to 1, and the disease was most common in the eighth decade of life. The majority of death was due to rupture (70%) or related atherosclerotic diseases (14%), and the majority of aneurysms were not suspected before autopsies (62%). Most of the non-dissecting aneurysms were found in the abdominal aorta, the infra-renal portion. For dissecting aneurysms, Daily's type A was much more common. Hypertension was recognized in a high proportion of cases. Accompanying diseases like syphilis, Takayasu's disease, ischemic heart disease, cerebrovascular accident, diabetes mellitus, peripheral vascular disease, and chronic obstructive airway disease were also noted.