INCREASING INCIDENCE OF ANEURYSMS OF THE ABDOMINAL-AORTA IN THE NETHERLANDS

Objectives: To study the trend in incidence of aneurysms of the abdomi nal aorta in The Netherlands during the past two decades. Setting: The Dutch population from 1972 to 1992. Design: Analysis of all hospital admissions and deaths due to aneurysms of the abdominal aorta. Outcome measures: Age adjusted and age specific mortality and discharge rates . In-hospital mortality after surgery upon aneurysms of the abdominal aorta. Results: From 1972 to 1992 age adjusted mortality from aneurysm s of the abdominal aorta rose from 3.1 to 8.1 per 100 000 in men, and from 1.4 to 2.2 in women. Age adjusted discharge rates (alive and dead ) for non-ruptured abdominal aortic aneurysms increased from 3.7 to 37 .6 per 100 000 in men and from 1.2 to 5.5 in women. For ruptured aneur ysms, the age adjusted discharge rates increased from 2.4 to 10.3 per 100 000 in men and from 0.7 to 1.7 in women. Age adjusted in-hospital mortality after surgery upon non-ruptured aneurysms was halved from 13 % in 1972 to 7% in 1992, mortality after acute repair upon ruptured an eurysms also decreased from 52% in 1972 to 36% in 1992. Conclusions: T here was an impressive increase in the hospital based incidence for an eurysms of the abdominal aorta during the past two decades in The Neth erlands. An improved detection rate through ultrasound is probably a m ajor contributor to this increase, but gender differences and the rise in the number of ruptured aneurysms suggest that a real increase in i ncidence may exist, especially in men. Surgical outcome for both ruptu red and non-ruptured aneurysms of the abdominal aorta improved.