Program for the Assessment of Radiological Technology, Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.
Br J Surg. 2010 Aug;97(8):1169-79. doi: 10.1002/bjs.7134.
The aim of this study was to assess possible differences in mortality between men and women with an abdominal aortic aneurysm (AAA) treated either by elective repair or following aneurysm rupture.
A systematic literature search was performed using the MEDLINE, Cochrane and Embase databases. Data were analysed by means of bivariate random-effects meta-analysis. Data were pooled and odds ratios (ORs) calculated for women compared with men.
Sixty-one studies (516 118 patients) met the predetermined inclusion criteria. Twenty-six reported on elective open AAA repair, 21 on elective endovascular repair, 25 on open repair for ruptured AAA and one study on endovascular repair for ruptured AAA. Mortality rates for women compared with men were 7.6 versus 5.1 per cent (OR 1.28, 95 per cent confidence interval (c.i.) 1.09 to 1.49) for elective open repair, 2.9 versus 1.5 per cent (OR 2.41, 95 per cent c.i. 1.14 to 5.15) for elective endovascular repair, and 61.8 versus 42.2 per cent (OR 1.16, 95 per cent c.i. 0.97 to 1.37) in the group that had open repair for rupture. The group that had endovascular repair for ruptured AAA was too small for meaningful analysis.
Women with an AAA had a higher mortality rate following elective open and endovascular repair.
本研究旨在评估接受择期修复或破裂后修复的男性和女性腹主动脉瘤（AAA）患者的死亡率是否存在差异。
使用 MEDLINE、Cochrane 和 Embase 数据库进行系统文献检索。通过双变量随机效应荟萃分析对数据进行分析。汇总数据并计算女性与男性的比值比（OR）。
61 项研究（516118 名患者）符合预定的纳入标准。26 项研究报告了择期开放 AAA 修复，21 项研究报告了择期血管内修复，25 项研究报告了破裂的开放修复，1 项研究报告了破裂的血管内修复。与男性相比，女性的死亡率分别为择期开放修复的 7.6%与 5.1%（OR 1.28，95%置信区间[CI]1.09 至 1.49）、择期血管内修复的 2.9%与 1.5%（OR 2.41，95%CI1.14 至 5.15）和破裂后开放修复的 61.8%与 42.2%（OR 1.16，95%CI0.97 至 1.37）。接受破裂后血管内修复的患者人数太少，无法进行有意义的分析。
女性接受择期开放和血管内修复的 AAA 死亡率更高。
