title: Time trends in hospital admissions and mortality due to abdominal aortic aneurysms in France, 2002-2013.
abstract: BACKGROUND
  Abdominal aortic aneurysms (AAA) are serious disease with a high fatality rate but recent epidemiologic data showed a decrease of AAA mortality. Our objective was to estimate, in France, the hospitalization, inhospital mortality and mortality rates due to AAA and to analyze their trends over time.
  
  
  METHODS
  Hospitalization data were extracted from the hospital discharge summaries in the national database between 2002 and 2013. The analysis covered all patients hospitalized for AAA as a principal diagnosis. During the same period, all death certificates mentioning AAA as an initial cause of death were included in the study. Crude and standardized rates were calculated according to age and sex. Poisson regression was used to analyze the average annual percent change.
  
  
  RESULTS
  In 2013, there were 8853 patients hospitalized for AAA in France (7986 unruptured and 867 ruptured). Between 2002 and 2013, the rate of patients hospitalized for unruptured AAA decreased slightly in men (-5.0%) but increased in women (+5.2%). By contrast, the rate of patients hospitalized for ruptured AAA has decreased by >20% in men and women. The proportion of endovascular treatment of unruptured AAA rose from <10% in 2005 to 35% in women and 40% in men in 2013. In 2013, 939 deaths from AAA were recorded. Mortality for this disease declined significantly from 2002 to 2013 in men and women.
  
  
  CONCLUSIONS
  The unfavorable epidemiological trends in women and important evolution of the management of AAA call for an epidemiological surveillance of this disease.
authors.affiliation: The French Public Health Agency, France.
authors.forename: M
authors.initials: M
authors.lastname: Robert
authors.affiliation: Department of Cardiology, Nancy University Hospital, Vandoeuvre-lès-Nancy, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Juillière
authors.affiliation: The French Public Health Agency, France.
authors.forename: A
authors.initials: A
authors.lastname: Gabet
authors.affiliation: Cardiology Center, Thionville, France.
authors.forename: S
authors.initials: S
authors.lastname: Kownator
authors.affiliation: The French Public Health Agency, France. Electronic address: valerie.olie@santepubliquefrance.fr.
authors.forename: V
authors.initials: V
authors.lastname: Olié
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000628:therapy; D016208:Databases, Factual / Q000706:statistics & numerical data; D019468:Disease Management; D005260:Female; D005602:France / Q000453:epidemiology; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D020380:Needs Assessment; D012737:Sex Factors
keywords: Abdominal aortic aneurysm; France; Hospitalization; Mortality; Time trends