Sex-related trends in mortality after elective abdominal aortic aneurysm surgery between 2002 and 2013 at National Health Service hospitals in England: less benefit for women compared with men
Authors' conclusion
Women undergoing elective AAA repair at National Health Service hospitals in England had increased short- and long-term mortality and post-operative morbidity compared with men.
Study context
- Population
- Patients undergoing elective abdominal aortic aneurysm (AAA) repair (open repair 2002–2013; Endovascular aneurysm repair (EVAR) 2006–2013) at NHS hospitals in Englandopen repair 31,090
- Exposure
- Women vs men undergoing elective AAA repair
- Outcome
- 30-day mortality
- Follow-up
- 30 days
Methodological detailsnational administrative datasets (Hospital Episode Statistics and Office for National Statistics (ONS))
- National administrative datasets (Hospital Episode Statistics and ONS)
Main finding
As reported in the abstract
Female sexOdds ratio (95% CI)P value
Open repair; independent risk factor
1.39(1.25–1.56)
P < 0.001EVAR; independent risk factor
1.57(1.23–2.00)
P < 0.001Observational data: associations, not effects.
Secondary outcomes
| Outcome | P value |
|---|---|
| Long-term all-cause mortality, conditional on 30-day survivalWomen vs Men · open repair: hazard significantly higher in women | P = 0.006 |
| Long-term all-cause mortality, conditional on 30-day survivalWomen vs Men · EVAR: sex difference not significant | P = 0.356 |
| Cumulative incidence of aortic-related and other-cause mortalityWomen vs Men | P < 0.001 |
| Cumulative incidence of aortic-related and other-cause mortalityWomen vs Men · EVAR: aortic-related mortality higher in women | P < 0.001 |
| Cumulative incidence of aortic-related and other-cause mortalityWomen vs Men · EVAR: other-cause mortality not significantly different | P = 0.235 |
- Cumulative incidence of aortic-related and other-cause mortality: open repair: higher in women for both aortic-related and other-cause mortality
Original publication
Sex-related trends in mortality after elective abdominal aortic aneurysm surgery between 2002 and 2013 at National Health Service hospitals in England: less benefit for women compared with men. Eur Heart J. Published 12 August 2016. doi:10.
Summarised from the published abstract; every number is checked against it