大腹大动脉动脉瘤的破裂风险:一个范围审查
Jitse H M Paping1, Ruth M A Bulder1, Elizabeth Lancaster2
1Department of Vascular Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Annals of vascular surgery
|November 2, 2025
概括
大于55毫米的腹腔大动脉动脉瘤 (AAA) 的破裂风险可能比以前认为的要低. 大多数研究都高估了破裂风险,没有考虑竞争的风险,除了一个大型的,最近的研究.
科学领域:
- 血管外科 血管外科
- 医学统计 医学统计
- 流行病学 流行病学
背景情况:
- 目前的腹腔大动脉瘤 (AAA) 管理依赖于55毫米的干预门.
- 这一门可能过于保守,目前关于超过55毫米的AAA破裂风险的争论仍在进行中.
研究的目的:
- 批判性地审查和总结有关大型AAA破裂风险的证据.
- 评估现有研究的准确性,考虑竞争的风险.
主要方法:
- 进行了全面的文献搜索.
- 对所确定的研究进行了定量和定性评估.
主要成果:
- 确定了20篇原创论文,显示出显著的异质性.
- 大多数研究可能高估了AAA破裂率,因为忽视了竞争风险.
- 最近的一项包含竞争性风险分析的大型研究估计了55-69毫米AAA的年度破裂率.
结论:
- 大多数报告中的直径破裂风险关系都是有缺陷的,因为没有考虑竞争风险.
- 较大的腹腔大动脉动脉瘤的实际破裂风险可能比通常认为的要低.
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