Methods:
Objectives :
The objective of the study was to compare the outcomes of ruptured AAAs
between males and females. We also compared the characters of the
patients presenting with the ruptured AAAs, the characteristics of the
aneurysms itself and post-operative course between males and females.
Sample:
The study was nested as a multi-center retrospective study and the
sample was obtained from two community-based sister hospitals located in
a metro city in Western New York. Over a period of 6 years, all the
patient charts admitted with a diagnosis of Abdominal Aortic Aneurysm in
the two hospitals were reviewed. The data was collected through a
retrospective review of paper charts and electronic medical records.
Approval was obtained from the Institution’s Review Board (IRB) of the
hospital system.
The inclusion criteria for the study were the patients who presented
with a rupture of the aneurysm. The patients who were admitted for
elective repair, endo-vascular leak or endo-vascular repair were
excluded.
Variables:
Demographic characters like age and gender, patient’s comorbidities
(hypertension, dyslipidemia, diabetes mellitus, cardiovascular
diseases), previous history of AAA (size at previous diagnosis, previous
attempt to repair and history of rupture), current use of
cardio-protective medications (statins, aspirin, clopidogrel and
beta-blockers), the characters of aneurysm (size, involvement of iliac
arteries) were noted and compared between males and females. They were
labeled as smokers if they smoked at least 100 cigarettes in their
lifetime. The hospital course including length of stay in ICU and
hospital, incidence and type of surgery, immediate post-operative
complications like ventilator dependent respiratory failure, hypovolemic
shock, acute renal failure, myocardial infarction were reviewed. The
immediate post-operative mortality and overall mortality with or without
surgery were noted. The long-term survival of the discharged patients
was identified using the SSN database. Patients discharged alive were
followed for a period of 2 years. Date of death was procured from
https://ladmf.ntis.gov (SSN database).
A total of 39 parameters were compared between males and females. The
patient data was kept confidential and the only primary investigators
had access to the data through a personal access key.
Statistical analysis:
SPSS version 26 was used for analysis of the study. We analyzed
between-group differences on demographic and baseline characteristics by
using chi-square tests for categorical variables and t-tests for
continuous variables. The predictors of mortality were projected based
on a logistic regression model, adjusting for age, hypertension, major
comorbidities, smoking status and use of preventive medications. We took
the p-value as less than 0.05 for statistical significance. Kaplan-Meier
survival curve analysis was used to analyze the long-term survival of
these patients (2-year mortality).