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September 8, 2012Annals of Surgery

Changes in Abdominal Aortic Aneurysm Rupture and Short-Term Mortality, 1995–2008

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Why the study?

Did the introduction and expansion of EVAR reduce AAA rupture and short-term AAA-related mortality in Medicare beneficiaries between 1995 and 2008?

Population

407,931 Medicare beneficiaries between 1995 and 2008.

Design

Cohort

Follow-up

1995 to 2008

Authors

MSMarc L. SchermerhornBeth Israel Deaconess Medical CenterRBRodney P. BensleyHadassah Medical CenterKGKristina A. GilesMaineHealth

Discussion

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Implication

Temporal AAA mortality decline paralleled EVAR expansion; supports association in older patients but leaves causation unproven.

Structured PICO

Did the introduction and expansion of EVAR reduce AAA rupture and short-term AAA-related mortality in Medicare beneficiaries between 1995 and 2008?

P
Population
407,931 Medicare beneficiaries (338,278 undergoing intact AAA repair and 69,653 hospitalized with ruptured AAA) between 1995 and 2008.
I
Intervention
Endovascular aneurysm repair (EVAR) adoption over time (1995-2008)
O
Outcome
Standardized annual rates of AAA-related deaths due to either elective repair or rupturehard clinical

The expansion of EVAR is associated with a significant decline in AAA ruptures and short-term AAA-related mortality, particularly in patients older than 80 years.

Cite This Study

Schermerhorn et al. (2012) studied this question.

synapsesocial.com/papers/6a7d1c25469c795fc4278dcfhttps://doi.org/10.1097/sla.0b013e31826b4f91
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Age-standardized incidence of ruptured aortic aneurysm in a defined Swedish population between 1952 and 1988: mortality rate and operative results1992 · 84 citations
  2. 2Endovascular vs. Open Repair of Abdominal Aortic Aneurysms in the Medicare Population2008 · 812 citations
  3. 3Immediate Repair Compared with Surveillance of Small Abdominal Aortic Aneurysms2002 · 1,094 citations
  4. 4Persistent increase in the incidence of abdominal aortic aneurysm in Scotland, 1981–20002003 · 81 citations