Hospitalization rates and post-operative mortality for abdominal aortic aneurysm in Italy over the period 2000-2011

Luigi Sensi, Dario Tedesco, Stefano Mimmi, Paola Rucci, Emilio Pisano, Luciano Pedrini, Kathryn M. McDonald, Maria Pia Fantini

Research output: Contribution to journalArticle

Abstract

Background: Recent studies have reported declines in incidence, prevalence and mortality for abdominal aortic aneurysms (AAAs) in various countries, but evidence from Mediterranean countries is lacking. The aim of this study is to examine the trend of hospitalization and post-operative mortality rates for AAAs in Italy during the period 2000-2011, taking into account the introduction of endovascular aneurysm repair (EVAR) in 1990s. Methods: This retrospective cohort study was carried out in Emilia-Romagna, an Italian region with 4.5 million inhabitants. A total of 19,673 patients hospitalized for AAAs between 2000 and 2011, were identified from the hospital discharge records (HDR) database. Hospitalization rates, percentage of OSR and EVAR and 30-day mortality rates were calculated for unruptured (uAAAs) and ruptured AAAs (rAAAs). Results: Adjusted hospitalization rates decreased on average by 2.9% per year for uAAAs and 3.2% for rAAAs (p<0.001). The temporal trend of 30-day mortality rates remained stable for both groups. The percentage of EVAR for uAAAs increased significantly from 2006 to 2011 (42.7 versus 60.9% respectively, mean change of 3.9% per year, p<0.001). No significant difference in mortality was found between OSR and EVAR for uAAAs and rAAAs. Conclusions: The incidence and trend of hospitalization rates for rAAAs and uAAAs decreased significantly in the last decade, while 30-day mortality rates in operated patients remained stable. OSR continued to be the most common surgery in rAAAs, although the gap between OSR and EVAR recently declined. The EVAR technique became the preferred surgery for uAAAs since 2008.

Original languageEnglish (US)
Article numbere83855
JournalPloS one
Volume8
Issue number12
DOIs
StatePublished - Dec 30 2013
Externally publishedYes

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aneurysm
Abdominal Aortic Aneurysm
Italy
Aneurysm
Hospitalization
Repair
Mortality
Surgery
Aortic Rupture
Hospital Records
Incidence
surgery
Cohort Studies
Retrospective Studies
incidence
Databases
cohort studies
Mediterranean region

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this

Sensi, L., Tedesco, D., Mimmi, S., Rucci, P., Pisano, E., Pedrini, L., ... Fantini, M. P. (2013). Hospitalization rates and post-operative mortality for abdominal aortic aneurysm in Italy over the period 2000-2011. PloS one, 8(12), [e83855]. https://doi.org/10.1371/journal.pone.0083855

Hospitalization rates and post-operative mortality for abdominal aortic aneurysm in Italy over the period 2000-2011. / Sensi, Luigi; Tedesco, Dario; Mimmi, Stefano; Rucci, Paola; Pisano, Emilio; Pedrini, Luciano; McDonald, Kathryn M.; Fantini, Maria Pia.

In: PloS one, Vol. 8, No. 12, e83855, 30.12.2013.

Research output: Contribution to journalArticle

Sensi, Luigi ; Tedesco, Dario ; Mimmi, Stefano ; Rucci, Paola ; Pisano, Emilio ; Pedrini, Luciano ; McDonald, Kathryn M. ; Fantini, Maria Pia. / Hospitalization rates and post-operative mortality for abdominal aortic aneurysm in Italy over the period 2000-2011. In: PloS one. 2013 ; Vol. 8, No. 12.
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abstract = "Background: Recent studies have reported declines in incidence, prevalence and mortality for abdominal aortic aneurysms (AAAs) in various countries, but evidence from Mediterranean countries is lacking. The aim of this study is to examine the trend of hospitalization and post-operative mortality rates for AAAs in Italy during the period 2000-2011, taking into account the introduction of endovascular aneurysm repair (EVAR) in 1990s. Methods: This retrospective cohort study was carried out in Emilia-Romagna, an Italian region with 4.5 million inhabitants. A total of 19,673 patients hospitalized for AAAs between 2000 and 2011, were identified from the hospital discharge records (HDR) database. Hospitalization rates, percentage of OSR and EVAR and 30-day mortality rates were calculated for unruptured (uAAAs) and ruptured AAAs (rAAAs). Results: Adjusted hospitalization rates decreased on average by 2.9{\%} per year for uAAAs and 3.2{\%} for rAAAs (p<0.001). The temporal trend of 30-day mortality rates remained stable for both groups. The percentage of EVAR for uAAAs increased significantly from 2006 to 2011 (42.7 versus 60.9{\%} respectively, mean change of 3.9{\%} per year, p<0.001). No significant difference in mortality was found between OSR and EVAR for uAAAs and rAAAs. Conclusions: The incidence and trend of hospitalization rates for rAAAs and uAAAs decreased significantly in the last decade, while 30-day mortality rates in operated patients remained stable. OSR continued to be the most common surgery in rAAAs, although the gap between OSR and EVAR recently declined. The EVAR technique became the preferred surgery for uAAAs since 2008.",
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AU - Pisano, Emilio

AU - Pedrini, Luciano

AU - McDonald, Kathryn M.

AU - Fantini, Maria Pia

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AB - Background: Recent studies have reported declines in incidence, prevalence and mortality for abdominal aortic aneurysms (AAAs) in various countries, but evidence from Mediterranean countries is lacking. The aim of this study is to examine the trend of hospitalization and post-operative mortality rates for AAAs in Italy during the period 2000-2011, taking into account the introduction of endovascular aneurysm repair (EVAR) in 1990s. Methods: This retrospective cohort study was carried out in Emilia-Romagna, an Italian region with 4.5 million inhabitants. A total of 19,673 patients hospitalized for AAAs between 2000 and 2011, were identified from the hospital discharge records (HDR) database. Hospitalization rates, percentage of OSR and EVAR and 30-day mortality rates were calculated for unruptured (uAAAs) and ruptured AAAs (rAAAs). Results: Adjusted hospitalization rates decreased on average by 2.9% per year for uAAAs and 3.2% for rAAAs (p<0.001). The temporal trend of 30-day mortality rates remained stable for both groups. The percentage of EVAR for uAAAs increased significantly from 2006 to 2011 (42.7 versus 60.9% respectively, mean change of 3.9% per year, p<0.001). No significant difference in mortality was found between OSR and EVAR for uAAAs and rAAAs. Conclusions: The incidence and trend of hospitalization rates for rAAAs and uAAAs decreased significantly in the last decade, while 30-day mortality rates in operated patients remained stable. OSR continued to be the most common surgery in rAAAs, although the gap between OSR and EVAR recently declined. The EVAR technique became the preferred surgery for uAAAs since 2008.

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