ArticleJournal of the Chinese Medical Association : JCMA2024
Influence of endovascular surgery on abdominal aortic aneurysm management strategies from a national health insurance database survey.
Article in Journal of the Chinese Medical Association : JCMA, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAbdominal aortic aneurysm (AAA) is a significant global health concern, yet comprehensive population-based studies remain limited. This study aimed to evaluate the hospitalization rates, surgical trends, mortality, and reintervention rates for ruptured (r-AAA) and nonruptured (nr-AAA) AAA using data from a national health insurance database.
methodsA population-based retrospective cohort study was conducted utilizing data from the Taiwanese National Health Insurance Research Database from 2007 to 2018. The study included individuals aged 20 years and older with a newly diagnosed AAA.
resultsAmong 70 457 patients diagnosed with aortic aneurysm or dissection, 22 538 (32%) adult patients (≥20 years) were identified with AAA. The annual incidence of AAA ranged from 7.7 to 10.3 per 100 000 population, with r-AAA decreasing from 1.3 to 0.8 per 100 000 and nr-AAA from 9.0 to 6.8 per 100 000. Most patients with AAA were older adults (85%), with 15 392 (68%) hospitalized and 4885 (32%) undergoing surgery within 14 days of diagnosis. The use of endovascular aneurysm repair (EVAR) significantly increased from 28% to 96% over the study period. Long-term survival was higher in patients who underwent open surgical repair (OSR) compared to those who received EVAR or conservative management, irrespective of whether they had r-AAA or nr-AAA.
conclusionAAA predominantly affects older individuals, and the annual incidence shows a declining trend. Since the introduction of EVAR, its use has steadily increased while OSR rates have decreased. Although both EVAR and OSR are associated with reduced mortality in patients with r-AAA, OSR is linked to superior long-term survival outcomes.
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