Influence of atmospheric pressure on infrarenal abdominal aortic aneurysm rupture.
BACKGROUND
Meteorologic conditions have a significant impact on the occurrence of cardiovascular events. Previous studies have shown that abdominal aortic aneurysm rupture (AAAR) may be associated with atmospheric pressure, with conflicting results. Therefore, we aimed to further investigate the nature of the correlation between atmospheric pressure variations and AAAR.


METHODS
Hospital admissions related to AAAR between 2005-2009 were assessed in 19 districts of metropolitan France and correlated with geographically and date-matched mean atmospheric pressures. In parallel and from 2005-2009, all fatal AAARs as reported by death certificates were assessed nationwide and correlated to local atmospheric pressures at the time of aortic rupture.


RESULTS
Four hundred ninety-four hospital admissions related to AAAR and 6,358 deaths nationwide by AAAR were identified between 2005-2009. Both in-hospital ruptures and aneurysm-related mortality had seasonal variations, with peak/trough incidences in January and June, respectively. Atmospheric pressure peaks occurred during winter. Univariate analysis revealed a significant association (P < 0.001) of high mean atmospheric pressure values and AAAR. After multivariate analysis, mean maximum 1-month prerupture atmospheric pressure had a persistent correlation with both in-hospital relative risk (1.05 [95% confidence interval: 1.03-1.06]; P < 0.0001) and aneurysm rupture-related mortality relative risk (1.02 [95% confidence interval: 1.01-1.03]; P < 0.0001).


CONCLUSIONS
The annual incidence of AAAR is nonhomogeneous with a peak incidence in winter, and is independently associated with mean maximum 1-month prerupture atmospheric pressure.
Department of Surgery, Saint Antoine Hospital, Pierre et Marie Curie University, Paris, France. Electronic address: nicolasrobert94@gmail.com.
Nicolas
N
Robert
Georges Pompidou European Hospital, CIC 9201 Inserm, Paris, France.
Michael
M
Frank
Vascular Surgery Department, Henri Mondor Hospital, Creteil, France.
Laure
L
Avenin
Statistic Department, Henri Mondor Hospital, Creteil, France.
Francois
F
Hemery
Statistic Department, Henri Mondor Hospital, Creteil, France.
Jean Pierre
JP
Becquemin
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D001019:Aortic Rupture / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D001274:Atmospheric Pressure; D003644:Death Certificates; D018450:Disease Progression; D005260:Female; D005602:France / Q000453:epidemiology; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D012621:Seasons; D013997:Time Factors