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).