RUPTURED ABDOMINAL AORTIC-ANEURYSM - A POPULATION-BASED STUDY

Purpose: The purpose of this study was to make an analysis of all rupt ured abdominal aortic aneurysms in a defined population. Methods: An e pidemiologic analysis of ruptured abdominal aortic aneurysms (AAAs) wa s made in an urban population during a 16-year period. The study was r etrospective and covered a demographically defined population of 230,0 00 inhabitants in the city of Malmo, Sweden. Reports of all identified ruptured AAAs in Malmo from 1971 to 1986 were analyzed. The autopsy r ate in the city was 85% during this period. Results: Ruptured AAAs wer e found in 5.6 of 100,000 persons (8.4/100,000 men and 3.0/100,000 wom en). No increase was found during the study period after age and sex s tandardization. The age-specific incidence was highest (113/100,000) i n men 81 to 90 years old and (68/100,000) in women older than 90. The number of surgical interventions increased among men but not among wom en and the surgical mortality rate decreased from 86% to 43%. The over all mortality rate for ruptured AAA was 88%. The most common symptoms were abdominal pain and toss of consciousness. Conclusions: The validi ty of the study was based on a high autopsy rate. The incidence of ane urysm rupture was not tow compared with other Scandinavian studies, bu t was low in comparison with studies from the United Kingdom. No incre ase in standardized rupture incidence was found. To substantially decr ease the total mortality caused by rupture, operation must be performe d before rupture.