Epidemiology of Surgically Treated Abdominal Aortic Aneurysms in the United States, 1988 to 2000

Vascular ◽  
2004 ◽  
Vol 12 (4) ◽  
pp. 218-224 ◽  
Author(s):  
Reid M. Wainess ◽  
Justin B. Dimick ◽  
John A. Cowan ◽  
Peter K. Henke ◽  
James C. Stanley ◽  
...  
Keyword(s):  
United States ◽  
Length Of Stay ◽  
Nationwide Inpatient Sample ◽  
Operative Mortality ◽  
The United States ◽  
Aortic Aneurysms ◽  
Benchmark Data ◽  
Abdominal Aortic ◽  
Complex Procedure ◽  
Hospital Stays

Abdominal aortic aneurysm (AAA) repair is a complex procedure about which little information exists regarding trends in surgical practice in the United States. This study was undertaken to define benchmark data regarding performance and outcomes of conventional AAA repair that might be used in comparisons with endovascular AAA repair data. Patients undergoing repair of intact ( n = 87,728) or ruptured ( n = 16,295) AAAs in the Nationwide Inpatient Sample (NIS) for 1988 to 2000 were studied. The NIS represents a 20% stratified random sample of all discharges from US hospitals. Unadjusted and case mix-adjusted analyses of in-hospital mortality and length of stay were performed. The overall frequency of intact AAA repair remained relatively stable during the study period, ranging from 18.1 to 16.3 operations/100,000 adults between 1988 and 2000, respectively. The operative mortality rate for intact AAA repair decreased significantly ( p < .001) from 6.5% in 1988 to 4.3% in 2000. Length of stay following intact AAA repair also declined significantly ( p < .001) from a median of 11 days in 1988 (interquartile range [IQR] 9-15 days) to 7 days in 2000 (IQR 5–10 days). The incidence of ruptured AAA repair decreased significantly ( p < .001) from 4.2 to 2.6 operations/100,000 adults between 1988 and 2000, respectively. Mortality for ruptured AAA repair, averaging 45.6%, did not decrease significantly during the study period. Intact AAA repair by conventional means has become increasingly safe, with decreased operative mortality and shorter hospital stays. Ruptured AAA repair by conventional means has not become safer but has decreased in incidence, suggesting possible reductions in risk factors contributing to rupture, coupled with more timely intact AAA repairs.

Inflation Testing as a Means of Measuring Failure Strength of Aortic Tissue

2003 ◽  
Author(s):  
Jeffrey N. Kinkaid ◽  
Steven P. Marra ◽  
Francis E. Kennedy ◽  
Mark F. Fillinger
Keyword(s):  
United States ◽  
Abdominal Aortic Aneurysms ◽  
The United States ◽  
Aortic Aneurysms ◽  
Aortic Tissue ◽  
Failure Strength ◽  
Health Statistics ◽  
Mortality Risks ◽  
Abdominal Aortic ◽  
Risk Of Rupture

Abdominal Aortic Aneurysms (AAAs) are localized enlargements of the aorta. If untreated, AAAs will grow irreversibly until rupture occurs. Ruptured AAAs are usually fatal and are a leading cause of death in the United States, killing 15,000 per year (National Center for Health Statistics, 2001). Surgery to repair AAAs also carries mortality risks, so surgeons desire a reliable tool to evaluate the risk of rupture versus the risk of surgery.

Nonoperative Management of Abdominal Aortic Aneurysms

2015 ◽  
Author(s):  
John P. Davis ◽  
Gilbert R Upchurch Jr
Keyword(s):  
United States ◽  
Physical Examination ◽  
Nonoperative Management ◽  
Abdominal Aortic Aneurysms ◽  
The United States ◽  
Aortic Aneurysms ◽  
Surveillance Period ◽  
Abdominal Aortic ◽  
Normal Diameter ◽  
Average Adult

Abdominal aortic aneurysms (AAAs) are characterized by dilation of the abdominal aorta at least 1.5 times the normal diameter of the average adult, which is approximately 2 cm in men and 1.5 cm in women. Although the incidence is relatively low, this disease can be devastating, with AAAs accounting for roughly 15,000 deaths annually in the United States. This review covers the focused history and physical examination of a patient with a known AAA, evaluation of small and large AAAs, and surveillance of AAAs. Tables highlight recommendations for best medical management of small AAAs during the surveillance period, and information on nicotine replacement and nonnicotinic pharmacotherapy. Figures show a calcific rim consistent with the atherosclerotic rim of an AAA, a small AAA, a small inflammatory AAA, and age-adjusted effects of lifestyle characteristics and risk of AAA. An algorithm provides an approach to nonoperative management of stable AAAs. This review contains 5 figures, 3 tables, and 86 references.

Epidemiology of Surgically Treated Abdominal Aortic Aneurysms in the United States, 1988 to 2000

Vascular ◽  
2004 ◽  
Vol 12 (04) ◽  
pp. 218 ◽  
Author(s):  
Reid M. Wainess ◽  
Justin B. Dimick ◽  
John A. Cowan ◽  
Peter K. Henke ◽  
James C. Stanley ◽  
...  
Keyword(s):  
United States ◽  
Abdominal Aortic Aneurysms ◽  
The United States ◽  
Aortic Aneurysms ◽  
Abdominal Aortic

Towards the Prediction and Minimization of Device Failure for Endolvascular Grafts in Abdominal Aortic Aneurysms

2007 ◽  
Author(s):  
Ron Layman ◽  
Samy Missoum ◽  
Jonathan Vande Geest
Keyword(s):  
United States ◽  
Abdominal Aortic Aneurysm ◽  
Critical Diameter ◽  
Abdominal Aortic Aneurysms ◽  
The United States ◽  
Aortic Aneurysms ◽  
Infrarenal Aorta ◽  
Device Failure ◽  
Clinical Challenge ◽  
Abdominal Aortic

The local dilation of the infrarenal aorta, termed an abdominal aortic aneurysm (AAA), occurs over several years and may eventually lead to rupture, an event currently ranked the 15th leading cause of death in the United States [1, 2]. AAA can often remain quiescent and asymptomatic, making the diagnosis and treatment of AAA patients a clinical challenge. For patients whose AAAs dilate to a critical diameter there are two standard treatments: open surgical resection and endovascular repair (EVAR). EVAR involves inserting an endovascular graft into the aneurysm to prevent pressurization of the AAA cavity.

Evaluating the prevalence of abdominal aortic aneurysms in the United States through a national screening database

2021 ◽  
Vol 73 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Kelli L. Summers ◽  
Edmund K. Kerut ◽  
Claudie M. Sheahan ◽  
Malachi G. Sheahan
Keyword(s):  
United States ◽  
Abdominal Aortic Aneurysms ◽  
The United States ◽  
Aortic Aneurysms ◽  
Abdominal Aortic

Development of a Thrombus Mimic in Abdominal Aortic Aneurysms

2007 ◽  
Author(s):  
John H. Ashton ◽  
Jonathan P. Vande Geest
Keyword(s):  
United States ◽  
Cause Of Death ◽  
Growth And Development ◽  
Abdominal Aortic Aneurysms ◽  
The United States ◽  
Aortic Aneurysms ◽  
Western World ◽  
Abdominal Aortic ◽  
Significant Disease

Abdominal aortic aneurysms (AAAs) represent a significant disease in the western world as rupture of AAA is currently the 15th leading cause of death in the United States [1,2]. The rate of incidence of this disease is also thought to be increasing given the aging population. While AAA rupture is attributed to the gradual weakening of the wall, the mechanisms of aneurysm initiation, growth, and development remain relatively unclear. The role of biomechanics in the diagnosis and prevention of AAA rupture has been reported [3].

Hemodynamics in Human Abdominal Aortic Aneurysms During Rest and Simulated Exercise

2007 ◽  
Author(s):  
Andrea S. Les ◽  
Christopher P. Cheng ◽  
Mary T. Draney Blomme ◽  
C. Alberto Figueroa ◽  
John F. LaDisa ◽  
...  
Keyword(s):  
United States ◽  
Shear Stress ◽  
Wall Shear Stress ◽  
Surgical Repair ◽  
Abdominal Aortic Aneurysms ◽  
The United States ◽  
Aortic Aneurysms ◽  
High Particle ◽  
Abdominal Aortic ◽  
Natural Progression

Abdominal Aortic Aneurysms (AAAs) — the localized enlargement of the abdominal aorta — represent the 13th leading cause of death in the United States. The natural progression of small (3–5 cm) AAAs is 2–6% growth per year until rupture or surgical repair [1]. As AAAs enlarge, adverse hemodynamic conditions (including regions of low mean wall shear stress and high particle residence time) are exacerbated under normal resting conditions.

The Impact of BMI on Adult Blunt Trauma Outcomes

2019 ◽  
Vol 85 (12) ◽  
pp. 1354-1362
Author(s):  
Rahman Barry ◽  
Milad Modarresi ◽  
Rodrigo Aguilar ◽  
Jacqueline Sanabria ◽  
Thao Wolbert ◽  
...  
Keyword(s):  
United States ◽  
Mortality Rate ◽  
Length Of Stay ◽  
Blunt Trauma ◽  
Nationwide Inpatient Sample ◽  
The United States ◽  
Mortality Rates ◽  
Hospital Length Of Stay ◽  
Obese Patients ◽  
The Impact

Traumatic injuries account for 10% of all mortalities in the United States. Globally, it is estimated that by the year 2030, 2.2 billion people will be overweight (BMI ≥ 25) and 1.1 billion people will be obese (BMI ≥ 30). Obesity is a known risk factor for suboptimal outcomes in trauma; however, the extent of this impact after blunt trauma remains to be determined. The incidence, prevalence, and mortality rates from blunt trauma by age, gender, cause, BMI, year, and geography were abstracted using datasets from 1) the Global Burden of Disease group 2) the United States Nationwide Inpatient Sample databank 3) two regional Level II trauma centers. Statistical analyses, correlations, and comparisons were made on a global, national, and state level using these databases to determine the impact of BMI on blunt trauma. The incidence of blunt trauma secondary to falls increased at global, national, and state levels during our study period from 1990 to 2015, with a corresponding increase in BMI at all levels ( P < 0.05). Mortality due to fall injuries was higher in obese patients at all levels ( P < 0.05). Analysis from Nationwide Inpatient Sample database demonstrated higher mortality rates for obese patients nationally, both after motor vehicle collisions and mechanical falls ( P < 0.05). In obese and nonobese patients, regional data demonstrated a higher blunt trauma mortality rate of 2.4% versus 1.2%, respectively ( P < 0.05) and a longer hospital length of stay of 4.13 versus 3.26 days, respectively ( P = 0.018). The obesity rate and incidence of blunt trauma secondary to falls are increasing, with a higher mortality rate and longer length of stay in obese blunt trauma patients.

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