Nair Nisha, Shaw Caroline, Sarfati Diana, Stanley James
University of Otago Wellington School of Medicine and Health Sciences, Wellington.
N Z Med J. 2012 Feb 24;125(1350):10-20.
Abdominal aortic aneurysm (AAA) rupture has a high mortality. Four randomised controlled trials indicate significant mortality benefit from population screening for AAA. There is a lack of information on the epidemiology and burden of AAA disease in New Zealand, necessary to support policy in this area.
A retrospective analysis was conducted on a dataset consisting of all AAA deaths and all hospital discharges with a AAA diagnosis between 2002 and 2006. Analysis by age, sex, ethnicity, and operative status was performed.
On average, there were 267 elective repairs and 87 emergency repairs annually between 2002 and 2006. The operative mortality rate was 35.2% for emergency repair, and 6.7% for elective repair. There were about 236 known AAA-related deaths annually. Ninety-four percent of AAA deaths between 2002-2006 occurred in individuals >65 years. The case fatality for females was higher than males across every age group. The standardised mortality rate in Maori was twice as high as New Zealand Europeans.
This study provides essential information to evaluate the appropriateness and feasibility of AAA screening here. A population-based prevalence study is recommended, along with further investigation of high case fatality in females and high mortality in Maori.
腹主动脉瘤（AAA）破裂具有很高的死亡率。四项随机对照试验表明，对AAA进行人群筛查可显著降低死亡率。新西兰缺乏有关AAA疾病的流行病学和负担的信息，而这些信息对于支持该领域的政策至关重要。
对2002年至2006年间所有AAA死亡病例和所有诊断为AAA的医院出院病例组成的数据集进行回顾性分析。按年龄、性别、种族和手术状态进行分析。
2002年至2006年间，平均每年有267例择期修复手术和87例急诊修复手术。急诊修复手术的死亡率为35.2%，择期修复手术的死亡率为6.7%。每年约有236例已知的与AAA相关的死亡病例。2002年至2006年间，94%的AAA死亡病例发生在65岁以上的人群中。在每个年龄组中，女性的病死率均高于男性。毛利人的标准化死亡率是新西兰欧洲人的两倍。
本研究提供了重要信息，以评估在此处进行AAA筛查的适宜性和可行性。建议开展基于人群的患病率研究，并进一步调查女性的高病死率和毛利人的高死亡率。
