title: Atmospheric pressure and infra-renal abdominal aortic aneurysm rupture: a single observational study and a comprehensive review of literature.
abstract: BACKGROUND
  There have been various suggestions that abdominal aortic aneurysm rupture (rAAA) might have a seasonal variation depending on atmospheric pressure (AP) alteration. Despite above suggestions no study has yet examined the effect of fluctuation in AP on daily, seasonal, monthly, AAA size and co-morbidities to reach a conclusive outcome.
  
  
  METHODS
  A total of fifty (n = 50) ruptured AAA over a 5-year period were retrospectively studied. Local meteorological data on AP were obtained from UK Meteorological Office. The data was subjected to statistical analysis using Student's t-test, linear regression (Pearson correlation Coefficient) and Coefficient of determination to establish any casual link between AP and incidences of rAAA on daily, seasonal and monthly basis. The casual link was also assessed between AP, AAA size and co-morbidities. The outcome is presented in a format of comprehensive review of literature that detected only 6 papers in MEDLINE and EMBASE from 1951 to 2012 in UK.
  
  
  CONCLUSIONS
  There appears to be a significant correlation between mean monthly pressures and mean monthly rupture incidence (Pearson)(n = 12; r = -0.61; p < 0.034; rsq = 0.37). The periods of low AP are associated with higher incidence of rupture (rAAA n = 29 at mean atmospheric pressure 1012 mB Vs rAAA n = 12 at mean atmospheric pressure 1016 mB Vs rAAA n = 9 at mean atmospheric pressure of 1020 mB) in our study and all reviewed literature. In addition, no casual link between AP to co-morbidities (diabetes mellitus, hypertension ischaemic heart disease, chronic obstructive pulmonary disease) and AAA size could be established or found in the literature.
authors.affiliation: Mid Essex Hospitals Services NHS Trust, Department of Vascular Surgery, Broomfield Hospital, Essex CM1 7ET, UK. Alikordzadeh@gmail.com
authors.forename: Ali
authors.initials: A
authors.lastname: Kordzadeh
authors.forename: Alan
authors.initials: A
authors.lastname: Askari
authors.forename: Yiannis
authors.initials: Y
authors.lastname: Panayiotopoulos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017544:Aortic Aneurysm, Abdominal / Q000453:epidemiology / Q000473:pathology; D001019:Aortic Rupture / Q000453:epidemiology / Q000473:pathology; D001274:Atmospheric Pressure; D015897:Comorbidity; D006973:Hypertension; D012189:Retrospective Studies; D012621:Seasons; D006113:United Kingdom / Q000453:epidemiology