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December 23, 2005
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Gustavo S. Oderich, MD, Audra A. Noel, MD, Peter Gloviczki, MD, Thomas C. Bower, MD, Timothy M. Sullivan, MD, Manju Kalra, MD, Leanne Barry, RN, Christina M. Wood, MS, William S. Harmsen, MS.
Mayo Clinic, Rochester, MN, USA.
Purpose: Mortality after ruptured abdominal aortic aneurysm (RAAA) remains high, with women reported to have increased mortality in several series. Gender differences have also been identified in other cardiovascular procedures. The purpose of this study was to evaluate gender-related differences in RAAA patients.
Methods: We retrospectively reviewed patients with RAAA treated between January 2, 1980, and December 31st, 2004. Gender-related differences were analyzed using Wilcoxon Rank Sum or Chi-square tests. Logistic regression analysis identified factors independently associated with in-hospital mortality.
Results: Of 501 patients treated for RAAA, 91 were women (18%) and 410 (82%) were men. The overall in-hospital mortality was 43% and was higher in women (62%) vs. men (38%)(P < 0.001). Men and women had comparable cardiovascular risk factors and operative variables. Several variables demonstrated gender-related differences (P<0.05): women were older (mean, 79±8 vs. 73±8 years); had smaller aneurysms (6.7±1.7 vs. 7.6±1.9 cm); higher APACHE II scores (19±9 vs. 16±8); lower initial systolic blood pressure (62±43 vs. 77±47 mmHg); and lower initial hematocrit (30±7 vs. 32±8). For all patients, risk factors multivariately associated with in-hospital mortality were cardiac arrest (P < 0.001), advanced age (P < 0.001), higher APACHE II score (P = 0.005), lower initial hematocrit (; P < 0.001) and female gender (P = 0.06).
Conclusion: Women with RAAA had smaller aneurysms than men. Female gender was independently associated with a trend towards increased in-hospital mortality. Gender-related outcomes may be explained by more women of older age presenting with advanced hemorrhagic shock as compared to men.
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Gender-related differences in patients with ruptured abdominal aortic aneurysms
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Gustavo S. Oderich, MD, Audra A. Noel, MD, Peter Gloviczki, MD, Thomas C. Bower, MD, Timothy M. Sullivan, MD, Manju Kalra, MD, Leanne Barry, RN, Christina M. Wood, MS, William S. Harmsen, MS.
Mayo Clinic, Rochester, MN, USA.
Purpose: Mortality after ruptured abdominal aortic aneurysm (RAAA) remains high, with women reported to have increased mortality in several series. Gender differences have also been identified in other cardiovascular procedures. The purpose of this study was to evaluate gender-related differences in RAAA patients.
Methods: We retrospectively reviewed patients with RAAA treated between January 2, 1980, and December 31st, 2004. Gender-related differences were analyzed using Wilcoxon Rank Sum or Chi-square tests. Logistic regression analysis identified factors independently associated with in-hospital mortality.
Results: Of 501 patients treated for RAAA, 91 were women (18%) and 410 (82%) were men. The overall in-hospital mortality was 43% and was higher in women (62%) vs. men (38%)(P < 0.001). Men and women had comparable cardiovascular risk factors and operative variables. Several variables demonstrated gender-related differences (P<0.05): women were older (mean, 79±8 vs. 73±8 years); had smaller aneurysms (6.7±1.7 vs. 7.6±1.9 cm); higher APACHE II scores (19±9 vs. 16±8); lower initial systolic blood pressure (62±43 vs. 77±47 mmHg); and lower initial hematocrit (30±7 vs. 32±8). For all patients, risk factors multivariately associated with in-hospital mortality were cardiac arrest (P < 0.001), advanced age (P < 0.001), higher APACHE II score (P = 0.005), lower initial hematocrit (; P < 0.001) and female gender (P = 0.06).
Conclusion: Women with RAAA had smaller aneurysms than men. Female gender was independently associated with a trend towards increased in-hospital mortality. Gender-related outcomes may be explained by more women of older age presenting with advanced hemorrhagic shock as compared to men.
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