Fowkes F G, Macintyre C C, Ruckley C V
University of Edinburgh.
BMJ. 1989 Jan 7;298(6665):33-5. doi: 10.1136/bmj.298.6665.33.
The numbers of patients being admitted to hospital with aortic aneurysms have increased recently. A study was carried out to try to find out whether this was a true increase in incidence or whether it could be attributable to more accurate diagnosis and better surgical techniques. From analyses of routine statistics it was found that from 1950 to 1984 age standardised mortality rose 20-fold in men to 47.1 per 100,000 population and 11-fold in women to 22.2 per 100,000 and that this was mainly due to more deaths from abdominal aneurysms. Hospital admissions of men with abdominal aneurysms were found to have increased steadily from 1968 to 1983, but the increase for women admitted did not begin until 1978. An increase in both emergency and elective admissions and only a marginal fall in deaths in hospital (from 45% to 39%) suggest that admissions for abdominal aneurysms increased across a wide range of severity of disease. It is concluded for the following reasons that the true incidence of aortic aneurysms, particularly abdominal aneurysms, has been increasing in England and Wales: the trends are not wholly compatible with advances in diagnosis and surgery, there are inconsistencies by age and sex, and increases have occurred in the number of complicated as well as uncomplicated cases.
最近,因主动脉瘤入院的患者数量有所增加。开展了一项研究,试图弄清楚这是发病率的真正上升,还是可归因于更准确的诊断和更好的手术技术。通过对常规统计数据的分析发现,从1950年到1984年,男性年龄标准化死亡率上升了20倍,达到每10万人47.1例,女性上升了11倍,达到每10万人22.2例,这主要是由于腹主动脉瘤导致的死亡人数增加。研究发现,1968年至1983年期间,男性腹主动脉瘤患者的住院人数稳步增加,但女性患者的住院人数直到1978年才开始增加。急诊和择期入院人数均增加,且住院死亡率仅略有下降(从45%降至39%),这表明腹主动脉瘤患者入院时病情严重程度范围广泛。基于以下原因得出结论:在英格兰和威尔士,主动脉瘤,尤其是腹主动脉瘤的实际发病率一直在上升;这些趋势与诊断和手术的进展并不完全相符,存在年龄和性别的不一致情况,而且复杂病例和非复杂病例的数量均有所增加。