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Abdominal aortic aneurysm: a 12-year experience in the Grampian region, Scotland
A K Samy1, B J Wilson, J Engeset
1Vascular Unit, Aberdeen Royal Infirmary.
Insights
The incidence of abdominal aortic aneurysm (AAA) increased significantly in Scotland from 1980-1991. This rise in AAA cases may be linked to an aging population and improved diagnostics.
Area of Science:
- Vascular Surgery
- Epidemiology
- Public Health
Background:
- Abdominal aortic aneurysm (AAA) is a life-threatening condition.
- Understanding trends in AAA incidence is crucial for public health planning.
- Previous studies have indicated regional variations in AAA prevalence.
Purpose of the Study:
- To investigate the incidence and characteristics of abdominal aortic aneurysm (AAA) cases in the Grampian region of Scotland.
- To analyze trends in AAA diagnosis, patient demographics, and outcomes over a 12-year period.
- To assess the potential impact of population aging on AAA incidence.
Main Methods:
- Retrospective study of 638 hospital cases of abdominal aortic aneurysm (AAA) diagnosed between January 1980 and December 1991.
- Data extracted from the Scottish Morbidity Record Form 1 (SMR1).
- Analysis of case numbers, patient age and sex, rupture status, and hospital fatality rates.
Main Results:
- A significant increase in AAA diagnoses was observed, rising from 19 cases in 1980 to 84 in 1991.
- The proportion of patients over 75 years old increased notably, particularly in men.
- Ruptured AAA cases decreased from 73.7% to 32.1%, likely due to increased elective surgeries, with a fatality rate of 46.3% compared to 8.4% for intact cases.
Conclusions:
- The study suggests a true increase in the incidence of abdominal aortic aneurysm (AAA) in the Grampian region.
- Population aging appears to be a contributing factor to the rising AAA incidence.
- Improved diagnostic awareness and management strategies may have influenced the observed trends in ruptured AAA and fatality rates.
Abstract:
All the 638 new hospital cases of abdominal aortic aneurysm (AAA) diagnosed in the Grampian region of Scotland, over the 12-year period between January 1980 and December 1991, were studied. Information was obtained from the Scottish Morbidity Record Form 1 (SMR1). The number of AAA cases has risen from 19 in 1980 to 84 in 1991 totalling 638 cases in the 12-year study period. Of these, 29% were women, a percentage which remained fairly constant for each year of the study. The mean age of the study population was 73.8 years; higher in women (74.7 in intact and 76.6 in ruptured cases) than in men (71 in intact and 73.1 in ruptured cases). There was a significant increase in the percentage of patients over the age of 75 years (from 31.6% in 1980 to 41.7% in 1991) which was very marked in men (from 25% to 40%). This may indicate that ageing of the population is partly responsible for the apparent increased incidence of the disease. Ruptured AAA constituted 36.5% of all cases of which 76.4% were men. The rate of ruptured cases has dropped from 73.7% in 1980 to 32.1% in 1991 probably owing to operating on more elective cases. Analysis of hospital fatality, including unoperated cases, showed a fatality rate of 8.4% for intact cases as opposed to 46.3% for ruptured cases. Allowing for improved diagnostic techniques and clinical awareness of the disease, the figures suggest a true increase in the incidence of AAA in the Grampian region.