SORA

Advancing, promoting and sharing knowledge of health through excellence in teaching, clinical practice and research into the prevention and treatment of illness

Thresholds for Abdominal Aortic Aneurysm Repair in England and the United States.

Karthikesalingam, A; Vidal-Diez, A; Holt, PJ; Loftus, IM; Schermerhorn, ML; Soden, PA; Landon, BE; Thompson, MM (2016) Thresholds for Abdominal Aortic Aneurysm Repair in England and the United States. The New England Journal of Medicine, 375 (21). pp. 2051-2059. ISSN 0028-4793 https://doi.org/10.1056/NEJMoa1600931
SGUL Authors: Holt, Peter James Edward Thompson, Matthew Merfyn Loftus, Ian Karthikesalingam, Alan Prasana Vidal-Diez, Alberto

[img]
Preview
PDF Published Version
Available under License ["licenses_description_publisher" not defined].

Download (637kB) | Preview
[img] PDF Accepted Version
Restricted to Repository staff only
Available under License ["licenses_description_publisher" not defined].

Download (143kB)

Abstract

Background Thresholds for repair of abdominal aortic aneurysms vary considerably among countries. Methods We examined differences between England and the United States in the frequency of aneurysm repair, the mean aneurysm diameter at the time of the procedure, and rates of aneurysm rupture and aneurysm-related death. Data on the frequency of repair of intact (nonruptured) abdominal aortic aneurysms, in-hospital mortality among patients who had undergone aneurysm repair, and rates of aneurysm rupture during the period from 2005 through 2012 were extracted from the Hospital Episode Statistics database in England and the U.S. Nationwide Inpatient Sample. Data on the aneurysm diameter at the time of repair were extracted from the U.K. National Vascular Registry (2014 data) and from the U.S. National Surgical Quality Improvement Program (2013 data). Aneurysm-related mortality during the period from 2005 through 2012 was determined from data obtained from the Centers for Disease Control and Prevention and the U.K. Office of National Statistics. Data were adjusted with the use of direct standardization or conditional logistic regression for differences between England and the United States with respect to population age and sex. Results During the period from 2005 through 2012, a total of 29,300 patients in England and 278,921 patients in the United States underwent repair of intact abdominal aortic aneurysms. Aneurysm repair was less common in England than in the United States (odds ratio, 0.49; 95% confidence interval [CI], 0.48 to 0.49; P<0.001), and aneurysm-related death was more common in England than in the United States (odds ratio, 3.60; 95% CI, 3.55 to 3.64; P<0.001). Hospitalization due to an aneurysm rupture occurred more frequently in England than in the United States (odds ratio, 2.23; 95% CI, 2.19 to 2.27; P<0.001), and the mean aneurysm diameter at the time of repair was larger in England (63.7 mm vs. 58.3 mm, P<0.001). Conclusions We found a lower rate of repair of abdominal aortic aneurysms and a larger mean aneurysm diameter at the time of repair in England than in the United States and lower rates of aneurysm rupture and aneurysm-related death in the United States than in England. (Funded by the Circulation Foundation and others.).

Item Type: Article
Additional Information: From New England Journal of Medicine, Karthikesalingam, A; Vidal-Diez, A; Holt, P; Loftus, I; Schermerhorn, MD; Soden, PA; Landon, BE; Thompson, MM, Thresholds for Abdominal Aortic Aneurysm Repair in England and the United States, Volume 375 No. 21, Page No. 2051-2059 Copyright © (2016) Massachusetts Medical Society. Reprinted with permission.
Keywords: General & Internal Medicine, 11 Medical And Health Sciences
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Cardiac (INCCCA)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Vascular & Cardiac Surgery (INCCVC)
Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: The New England Journal of Medicine
ISSN: 0028-4793
Language: eng
Dates:
DateEvent
24 November 2016Published
28 July 2016Accepted
Publisher License: Publisher's own licence
PubMed ID: 27959727
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/108191
Publisher's version: https://doi.org/10.1056/NEJMoa1600931

Actions (login required)

Edit Item Edit Item