Sex-Based Differences in Ruptured Abdominal Aortic Aneurysm Management and Outcomes: An Update

Area of Science:

• Vascular Surgery
• Cardiovascular Research
• Health Disparities

Background:

• Ruptured abdominal aortic aneurysm (AAA) repair outcomes can differ significantly between sexes.
• Understanding these sex-based disparities is crucial for optimizing patient care and improving survival rates.

Purpose of the Study:

• To evaluate sex-based differences in mortality, morbidity, and postoperative complications following ruptured AAA repair.
• To identify specific risk factors and outcomes associated with sex in ruptured AAA patients.

Main Methods:

• Retrospective cohort study utilizing multi-institutional data from the Vascular Quality Initiative national database (2003-2022).
• Analysis included 7,548 patients (5,829 men, 1,719 women) undergoing open or endovascular repair for ruptured AAA.

Main Results:

• Mortality rates decreased significantly for both sexes over time.
• Men had higher rates of coronary artery disease and prior interventions, while women presented older, with more hypertension, and a longer delay from symptom onset to repair.
• Women exhibited higher in-hospital mortality (OR 1.27), while men had worse cardiovascular and pulmonary complications.

Conclusions:

• Significant sex-based disparities exist in ruptured AAA repair outcomes.
• Men present with higher comorbidity burdens, whereas women are older and experience delays in treatment.
• Sex-specific guidelines and interventions are essential to improve outcomes for all patients undergoing ruptured AAA repair.