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Population-based study of ruptured abdominal aortic aneurysm.
M T Laine1, S J Laukontaus2, I Kantonen2
1Department of Vascular Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. matti.laine@hus.fi.
The British Journal of Surgery
|August 11, 2016
Summary
Ruptured abdominal aortic aneurysm (rAAA) incidence and mortality are decreasing in southern Finland. However, high mortality persists due to patients dying before hospital arrival.
Area of Science:
- Vascular surgery
- Epidemiology
- Public health
Background:
- Abdominal aortic aneurysm (AAA) rupture incidence has shown a declining trend.
- This study investigates trends in ruptured AAA (rAAA) incidence within the Helsinki and Uusimaa (HUS) hospital district in Finland.
- A population-based retrospective review was conducted for the period 2003-2013.
Purpose of the Study:
- To evaluate temporal trends in the incidence of ruptured abdominal aortic aneurysms (rAAA).
- To assess the mortality rates associated with rAAA in a defined Finnish population.
- To analyze patient outcomes and treatment turn-down rates for rAAA.
Main Methods:
- Retrospective review of a population-based cohort of rAAA patients in the HUS district (1.5 million inhabitants).
- Data collected from the Helsinki University Hospital vascular registry and Statistics Finland's cause of death registry.
- Analysis included patient demographics, hospital arrival status, surgical treatment rates, and 30-day mortality.
Main Results:
- A total of 712 patients with rAAA were identified; 46.3% arrived alive at the hospital.
- The 30-day survival rate for all rAAA patients was 27.9%.
- The incidence of rAAA was 4.3 per 100,000 inhabitants, with a decreasing trend observed over the 11-year study period.
Conclusions:
- The incidence of ruptured abdominal aortic aneurysms (rAAA) is declining in the HUS district.
- Despite decreasing incidence, mortality from rAAA remains high, with a significant proportion of deaths occurring pre-hospital.
- Improved pre-hospital care and faster access to vascular surgery may be crucial for reducing rAAA mortality.
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