Gender differences in abdominal aortic aneurysm prevalence, treatment, and outcome.

PURPOSE: The purpose of this study was to investigate gender differences in the management of and outcome of surgery for abdominal aortic aneurysms (AAA).
METHODS: Hospital discharge data from all acute care hospitals in Michigan, as compiled in the Michigan Inpatient Data Base, were retrospectively analyzed to assess sex differences in regard to AAA prevalence, treatment, and surgical outcome from 1980 to 1990. This population database included 11,512 women and 29,846 men 50 years of age and older with diagnoses of intact or ruptured AAA.
RESULTS: Hospitalizations for intact or ruptured AAA were approximately five times more common among men compared with women. After controlling for age and year of surgery, men were 1.8 times as likely as women to have an intact AAA treated surgically and 1.4 times as likely to have a ruptured AAA treated surgically (95% confidence intervals, 1.7 to 1.9 and 1.2 to 1.7, respectively). Women who had operations for intact AAA had a 1.4 times greater risk of dying compared with men, and women who had operations for ruptured AAA had a 1.45 times greater risk of dying, after controlling for other predictors of death (95% confidence intervals, 1.14 to 1.73 and 1.10 to 1.90, respectively).
CONCLUSIONS: In a population-based statewide experience, women who had intact or ruptured AAA were less likely than men to undergo aortic reconstruction and, when they did, were less likely than men to survive to discharge.