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Gender-Based Differences in Abdominal Aortic Aneurysm Rupture: A Retrospective Study.
Srikrishna Varun Malayala1, Ambreen Raza2, Rachana Vanaparthy3
1Department of Medicine, Temple University Health System, Philadelphia, PA, USA.
Journal of Clinical Medicine Research
|January 15, 2021
Summary
Abdominal aortic aneurysm (AAA) rupture is more common in men, but women experience worse outcomes and smaller rupture sizes. Current screening guidelines for AAA do not include women, necessitating further research into high-risk female populations.
Area of Science:
- Vascular Surgery
- Epidemiology
- Public Health
Background:
- Abdominal aortic aneurysm (AAA) rupture causes 5% of sudden deaths annually.
- Females with AAA rupture experience worse outcomes and smaller aneurysm sizes compared to males.
- Current USPSTF guidelines recommend AAA screening for males aged 65-75 who have ever smoked, with insufficient evidence for females.
Purpose of the Study:
- To compare the characteristics, mortality, and morbidity of ruptured abdominal aortic aneurysms (AAAs) in females versus males.
Main Methods:
- Retrospective review of 117 patients over 6 years from two institutions.
- Comparison of 39 parameters between males and females, including demographics, comorbidities, aneurysm characteristics, and surgical outcomes.
- Analysis of postoperative complications and long-term survival rates.
Main Results:
- AAA rupture incidence was higher in males (68%) than females (32%).
- Females had significantly smaller ruptured AAA sizes (7.4 cm vs. 8.2 cm) and lower surgical probability (P=0.03).
- Females experienced higher overall mortality (P=0.001), postoperative mortality (P=0.02), and increased ICU stay and complications.
Conclusions:
- Current AAA size thresholds for elective surgery may not be appropriate for both sexes.
- Further population-based studies are required to support AAA screening for high-risk females due to their elevated morbidity and mortality.
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