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. 2017 Dec 21;7(1):17994.
doi: 10.1038/s41598-017-18451-2.

Persisting disparities between sexes in outcomes of ruptured abdominal aortic aneurysm hospitalizations

Mark Stuntz  1 , Céline Audibert  2 , Zheng Su  2
Affiliations

Persisting disparities between sexes in outcomes of ruptured abdominal aortic aneurysm hospitalizations

Mark Stuntz et al. Sci Rep. .

Abstract

We sought to describe and analyze discrepancies between sexes in the outcomes of patients hospitalized for ruptured abdominal aortic aneurysms (rAAA) by conducting a retrospective analysis of the Nationwide Inpatient Sample. The review included all adult patients (≥18 years old) hospitalized with a primary diagnosis of rAAA between January 2002 and December 2014. In-hospital mortality differences between females and males were analyzed overall and separately among those receiving endovascular AAA repair (EVAR) or open AAA repair (OAR). In-hospital mortality for females declined from 61.0% in 2002 to 49.0% in 2014 (P for trend <0.001), while mortality for males declined from 48.6% in 2002 to 32.2% in 2014 (P for trend <0.001). Among those receiving EVAR, females were significantly more likely to die in the hospital than males (adjusted odds ratio [OR], 1.44; 95% CI, 1.12-1.84). In addition, the odds of mortality among those receiving OAR were higher for females than males (adjusted OR, 1.14; 95% CI: 1.00-1.31). These data provide evidence that despite overall decreasing trends in mortality for both sexes, females remain at higher risk of death compared with males regardless of surgical repair procedure.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Temporal trends in rate of hospitalizations per 100,000 adults and adjusted mean charges for stays with primary diagnosis of rAAA. Mean hospitalization charges for each year have been adjusted to 2014 inflation dollars. Error bars indicate SE.
Figure 2
Figure 2
Temporal trends for rAAA in-hospital mortality among males and females.
Figure 3
Figure 3
Temporal trends for rAAA surgical repair utilization and mortality. (A) There were significant (P for trend <0.001) increasing trends for both males and females in utilization of EVAR; (B) significant (P for trend <0.001) decreasing trends for both males and females in utilization of OAR; (C) significant (P for trend <0.001) decreasing trend in mortality among males receiving EVAR, and no significant change among females (P for trend =0.51); (D) significant (P for trend <0.001) decreasing trend in mortality among males receiving OAR, and no statistically significant change among females (P for trend =0.06).
Figure 4
Figure 4
Risk-adjusted mortality odds ratios by year for females vs males.
See this image and copyright information in PMC

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