Outcome after abdominal aortic aneurysm repair. Difference between men and women

Objectives. To evaluate short- and long-term outcome after open repair for ruptured and non-ruptured abdominal aortic aneurysm (AAA) with special emphasis on the difference between men and women. Design. Single center retrospective study. Time and cause of death were determined from hospital charts, the National Bureau of Statistics and the Department for National Health and Welfare. Materials. Eight hundred and forty-six patients were followed-up, 597 were operated on for non-ruptured and 249 for ruptured aneurysms. Methods. Case fatality was analyzed by multiple logistic regression considering year of surgery, age at surgery, and gender as covariates. The mortality rate for patients surviving 60 days after surgery was compared with the mortality in the general population by calculating the standardised mortality ratio (SMR). Mortality was also stratified according to gender and type of surgery. Results. The SMR for patients surviving 60 days after surgery was significantly increased. SMR was significantly higher for women than for men. There was no statistically significant difference in SMR between patients operated for rupture compared to those operated for non-ruptured aneurysms. Conclusions. Women with AAA have a poorer outcome than women in the general population. This finding may relate to the large number of risk factors present in this patient sub-group.