title: Treatment of abdominal aortic aneurysm in nine countries 2005-2009: a vascunet report.
abstract: OBJECTIVE
  To study contemporary treatment and outcome of abdominal aortic aneurysm (AAA) repair in nine countries.
  
  
  METHODS
  Data on primary AAA repairs 2005-2009 were amalgamated from national and regional vascular registries in Australia, Denmark, Finland, Hungary, Italy, Norway, Sweden, Switzerland and the UK. Primary outcome was in-hospital or 30-day mortality. Multivariate logistic regression was used to assess case-mix.
  
  
  RESULTS
  31,427 intact AAA repairs were identified, mean age 72.6 years (95% CI 72.5-72.7). The rate of octogenarians and use of endovascular repair (EVAR) increased over time (p < 0.001). EVAR varied between countries from 14.7% (Finland) to 56.0% (Australia). Overall perioperative mortality after intact AAA repair was 2.8% (2.6-3.0) and was stable over time. The perioperative mortality rate varied from 1.6% (1.3-1.8) in Italy to 4.1% (2.4-7.0) in Finland. Increasing age, open repair and presence of comorbidities were associated with outcome. 7040 ruptured AAA repairs were identified, mean age 73.8 (73.6-74.0). The overall perioperative mortality was 31.6% (30.6-32.8), and decreased over time (p = 0.004).
  
  
  CONCLUSIONS
  The rate of AAA repair in octogenarians as well as EVAR increased over time. Perioperative outcome after intact AAA repair was stable over time, but improved after ruptured repair. Geographical differences in treatment of AAA remain.
authors.affiliation: Department of Vascular Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK. kevin.mani@surgsci.uu.se
authors.forename: K
authors.initials: K
authors.lastname: Mani
authors.forename: T
authors.initials: T
authors.lastname: Lees
authors.forename: B
authors.initials: B
authors.lastname: Beiles
authors.forename: L P
authors.initials: LP
authors.lastname: Jensen
authors.forename: M
authors.initials: M
authors.lastname: Venermo
authors.forename: G
authors.initials: G
authors.lastname: Simo
authors.forename: D
authors.initials: D
authors.lastname: Palombo
authors.forename: E
authors.initials: E
authors.lastname: Halbakken
authors.forename: T
authors.initials: T
authors.lastname: Troëng
authors.forename: P
authors.initials: P
authors.lastname: Wigger
authors.forename: M
authors.initials: M
authors.lastname: Björck
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000628:therapy*; D001019:Aortic Rupture / Q000401:mortality / Q000628:therapy*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D010818:Practice Patterns, Physicians'; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome