Predictors of repair and effect of gender on treatment of ruptured abdominal aortic aneurysm.
OBJECTIVE
The purpose of this study was to determine factors associated with increased likelihood of patients undergoing surgery to repair ruptured abdominal aortic aneurysms (AAAs). Specifically, we investigated whether men were more likely than women to be selected for surgery after rupture of AAAs.


METHODS
All patients with a ruptured AAA who came to a hospital in Ontario between April 1, 1992, and March 31, 2001, were included in this population-based retrospective study. Administrative data were used to identify patients, patient demographic data, and hospital variables.


RESULTS
Crude 30-day mortality for the 3570 patients who came to a hospital with a ruptured AAA was 53.4%. Of the 2602 patients (72.9%) who underwent surgical repair, crude 30-day mortality was 41.0%. Older patients (odds ratio [OR], 0.649 per 5 years of age; P<.0001), with a higher Charlson Comorbidity Index (OR, 0.848; P<.0001), were less likely to undergo AAA repair. Patients treated at high-volume centers (OR, 2.674 per 10 cases; P<.0001) and men (OR, 2.214; P<.0001) were more likely to undergo AAA repair.


CONCLUSIONS
Men are more likely to undergo repair of a ruptured AAA than women are, for reasons that are unclear. Given the large magnitude of the effect, further studies are clearly indicated.
Dueck
Andrew D
AD
Department of Surgery, University of Toronto, Ontario, Canada.
Johnston
K Wayne
KW
Alter
David
D
Laupacis
Andreas
A
Kucey
Daryl S
DS
D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000453:epidemiology / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000453:epidemiology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis