title: Shifting abdominal aortic aneurysm mortality trends in The Netherlands.
abstract: OBJECTIVE
  Mortality from abdominal aortic aneurysm (AAA) in developed countries has decreased since the late 1990s. Our objective was to get an insight of mortality trends in The Netherlands for AAA disease.
  
  
  METHODS
  Data of all AAA deaths (1980 to 2010) were collected from the Dutch cause of death register. Cause of death was divided in two groups: with the mention of rupture and without the mention of rupture. Data were standardized and divided into three age groups (55-69, 70-84, and ≥85 years). Mortality rates per 100,000 were analyzed for both sexes and for each age group. Significant points of change were identified using joinpoint regression analysis.
  
  
  RESULTS
  Total standardized AAA mortality increased from 1980 (1062 deaths) until 1995 (1728 deaths), followed by a decline until 2010 (930 deaths). This decline was most prominent in men. Deaths without mention of rupture showed an increase from 1980 until 2010. The age of AAA death was higher in women (79.2 in 1980 and 82.1 in 2010) than in men. This difference declined as the age of death from AAA increased from 72.1 in 1980 to 77.9 years in 2010 in men. Decline in AAA mortality was first seen in the young age group (55-69 years) and then seen consecutively older age groups.
  
  
  CONCLUSIONS
  Mortality from AAA is declining due to a reduction in deaths from ruptured AAAs. This was first observed in the young age groups. Men died more often and at a lower age.
authors.affiliation: Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: b.g.1.nelissen@gmail.com.
authors.forename: Bastiaan G L
authors.initials: BG
authors.lastname: Nelissen
authors.affiliation: Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Joost A
authors.initials: JA
authors.lastname: Herwaarden
authors.affiliation: Department of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Gerard
authors.initials: G
authors.lastname: Pasterkamp
authors.affiliation: Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Frans L
authors.initials: FL
authors.lastname: Moll
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Ilonca
authors.initials: I
authors.lastname: Vaartjes
mesh_terms: D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000401:mortality*; D001019:Aortic Rupture / Q000175:diagnosis / Q000401:mortality*; D002423:Cause of Death / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D013997:Time Factors