Influence of gender on outcome from ruptured abdominal aortic aneurysm

Background: The aim of the present study was to compare outcomes following ruptured abdominal aortic aneurysm (AAA) in men and women. Methods: Overall mortality from ruptured AAA was compared in men and women using the Western Australia Health Services Research Database. The linked c hains of de-identified hospital morbidity and death records were selected u sing the ICD-9-CM (International Classification of Diseases - Clinical Modi fication) diagnostic and procedure codes pertaining to AAA. Cases were divi ded into three groups for analysis: patients who died without admission to hospital, those admitted to hospital with a ruptured AAA but who did not un dergo operation, and patients who underwent operation for ruptured AAA. Results: Ruptured AAA occurred in 648 men and 225 women over the age of 55 years during the decade 1985-1994. Only 50 per cent of women, compared with 59 per cent of men, were admitted to hospital. Of those admitted to hospit al only 37 per cent of women underwent operation, compared with 63 per cent of men. The overall mortality rate from ruptured AAA was 90 per cent in wo men and 76 per cent in men (chi(2) = 50.34, 1 d.f., P < 0.0001). Although w omen were, on average, 6 years older than men, this unfavourable pattern oc curred across all age groups. Conclusion: Women with a ruptured AAA are more likely to die than men. More research is required to identify the causes of this sex difference.