Relatively high pulmonary and cardiovascular mortality rates in screening-detected aneurysmal patients without previous hospital admissions.
BACKGROUND
Men with abdominal aortic aneurysm (AAA) who are not hospitalised for pulmonary and cardiovascular diseases may have higher mortality due to such disorders.


METHODS
Previous discharge diagnoses and causes of death were collected for 4,816 men aged 64-73 years attending mass screening for AAA. Of these, 191 (4%) had an AAA. Overall, cardiovascular- and pulmonary-disease-specific mortality was compared for men with and without AAA stratified for earlier pulmonary or cardiovascular hospitalisations by Cox's proportional hazards regression while adjusting for age. Absolute risk differences after five years were calculated by life table analysis.


RESULTS
The median observation time was 63 months. 362 men died from cardiovascular causes other than AAA, and 144 died from pulmonary causes. The cardiovascular mortality was significantly higher in aneurysm patients without previous related hospitalisation (HR=4.35, 95% CI: 2.73-6.94, P<0.001) with an absolute mortality difference after 5 years of 16.3% (95% CI: 10.2-22.5%). Pulmonary-cause mortality was higher among men with AAA both with and without previous hospitalisation for pulmonary causes (HR=3.05; 95% CI: 1.19-7.83, P=0.020, and HR=3.29; 95% CI: 1.78-6.08, P<0.001, respectively).


CONCLUSIONS
Men with AAA who had not been hospitalised for cardiovascular diseases have more than four times higher cardiovascular mortality. Studies of cohorts being offered relevant prophylaxis may clarify the potential benefits of general preventive actions.
Lindholt
J S
JS
Vascular Research Unit, Department of Vascular Surgery, Viborg Hospital, Viborg, Denmark. Jes.S.Lindholt@Sygehusviborg.dk
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000453:epidemiology / Q000401:mortality*; D002318:Cardiovascular Diseases / Q000150:complications / Q000401:mortality*; D003718:Denmark / Q000453:epidemiology; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000401:mortality; D002546:Ischemic Attack, Transient / Q000401:mortality; D015993:Life Tables; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D017202:Myocardial Ischemia / Q000401:mortality; D016491:Peripheral Vascular Diseases / Q000401:mortality; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality; D012140:Respiratory Tract Diseases / Q000150:complications / Q000401:mortality*; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors