title: Impact of gender and body surface area on outcome after abdominal aortic aneurysm repair.
abstract: BACKGROUND
  A gender-neutral threshold aneurysm diameter (AD) of more than 5.5 cm for surgical intervention in abdominal aortic aneurysms (AAA) ignores the fact that women have a smaller baseline AD. We hypothesized that women have a greater AD relative to body surface area (BSA) at the time of surgery and that this worsens outcome.
  
  
  METHODS
  The Vascular Study Group of New England database was queried for elective AAA repairs performed from 2003 to 2011 to compare BSA-indexed AD, ie, aortic size index (ASI), between men and women at the time of surgery and the impact of ASI on outcome.
  
  
  RESULTS
  Women were older and had higher ASI among both open-repair (n = 1,566) and endovascular repair (n = 2,172) patients (P < .001). Among open-repair patients, mean ASI for men undergoing repair at AD of 5.5 cm (2.75 cm/m²) was used to subdivide women into 2 categories: women with ASI of 2.75 or more were older (P < .001), had a larger aneurysm size (P < .001), and had a higher 1-year mortality (P = .042) than women with ASI less than 2.75.
  
  
  CONCLUSIONS
  When indexed to BSA, women have a larger aneurysm size than men at the time of AAA repair.
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, West Campus, Lowry Medical Office Building, 110 Francis Street, Boston, MA 02215, USA.
authors.forename: Robina
authors.initials: R
authors.lastname: Matyal
authors.affiliation: Department of Surgery, Harvard Medical School, West Campus, Lowry Medical Office Building, 110 Francis Street, Boston, MA 02215, USA. Electronic address: oshakil@bidmc.harvard.edu.
authors.forename: Omair
authors.initials: O
authors.lastname: Shakil
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, West Campus, Lowry Medical Office Building, 110 Francis Street, Boston, MA 02215, USA.
authors.forename: Philip E
authors.initials: PE
authors.lastname: Hess
authors.affiliation: Department of Surgery, Harvard Medical School, West Campus, Lowry Medical Office Building, 110 Francis Street, Boston, MA 02215, USA.
authors.forename: Ruby
authors.initials: R
authors.lastname: Lo
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, West Campus, Lowry Medical Office Building, 110 Francis Street, Boston, MA 02215, USA.
authors.forename: Jayant S
authors.initials: JS
authors.lastname: Jainandunsing
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, West Campus, Lowry Medical Office Building, 110 Francis Street, Boston, MA 02215, USA.
authors.forename: Bilal
authors.initials: B
authors.lastname: Mahmood
authors.affiliation: Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
authors.forename: Greg S
authors.initials: GS
authors.lastname: Hartman
authors.affiliation: Department of Surgery, Harvard Medical School, West Campus, Lowry Medical Office Building, 110 Francis Street, Boston, MA 02215, USA.
authors.forename: Marc L
authors.initials: ML
authors.lastname: Schermerhorn
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, West Campus, Lowry Medical Office Building, 110 Francis Street, Boston, MA 02215, USA.
authors.forename: Feroze
authors.initials: F
authors.lastname: Mahmood
mesh_terms: D000367:Age Factors; D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D001830:Body Surface Area; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012737:Sex Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures
keywords: Abdominal aortic aneurysm; Aortic size index; Body surface area; Endovascular repair