Lopez-de-Andrés Ana, Jiménez-Trujillo Isabel, Jiménez-García Rodrigo, Hernández-Barrera Valentín, de Miguel-Yanes José M, Méndez-Bailón Manuel, Perez-Farinos Napoleón, Salinero-Fort Miguel Ángel, Carrasco-Garrido Pilar
Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Avda. de Atenas s/n, 28922, Alcorcon, Comunidad deMadrid, Spain.
Medicine Department, Hospital Gregorio Marañon, Comunidad de Madrid, Spain.
Cardiovasc Diabetol. 2015 May 7;14:48. doi: 10.1186/s12933-015-0216-1.
This study aims to describe trends in the rate of abdominal aortic aneurysm (AAA) and use of open surgery repair (OSR) and endovascular aneurysm repair (EVAR) in elderly patients with and without type 2 diabetes in Spain, 2003-2012.
We select all patients with a discharge of AAA using national hospital discharge data. Discharges were grouped by diabetes status: type 2 diabetes and no diabetes. In both groups OSR and EVAR were identified. The incidence of discharges attributed to AAA were calculated overall and stratified by diabetes status and year. We calculated length of stay (LOHS) and in-hospital mortality (IHM). Use of OSR and EVAR were calculated stratified by diabetes status. Multivariate analysis was adjusted by age, sex, year, smoking habit and comorbidity.
From 2003 to 2012, 115,020 discharges with AAA were identified. The mean age was 74.91 years and 16.7% suffered type 2 diabetes. Rates of discharges due to AAA increased significantly in diabetic patients (50.09 in 2003 to 78.23 cases per 100,000 in 2012) and non diabetic subjects (69.24 to 78.66). The incidences were higher among those without than those with diabetes in all the years studied. The proportion of patients that underwent EVAR increased for both groups of patients and the open repair decreased. After multivariate analysis we found that LOHS and IHM have improved over the study period and diabetic patients had lower IHM than those without diabetes (OR 0.81; 95%CI 0.76-0.85).
Incidence rates were higher in non-diabetic patients. For diabetic and non diabetic patients the use of EVAR has increased and open repair seems to be decreasing. IHM and LOHS have improved from 2003 to 2012. Patients with diabetes had significantly lower mortality.
本研究旨在描述2003年至2012年西班牙老年2型糖尿病患者和非2型糖尿病患者腹主动脉瘤（AAA）发生率以及开放手术修复（OSR）和血管内动脉瘤修复（EVAR）的使用趋势。
我们使用国家医院出院数据选取所有诊断为AAA的患者。出院患者按糖尿病状态分组：2型糖尿病和非糖尿病。在两组中识别出OSR和EVAR。总体计算并按糖尿病状态和年份分层计算归因于AAA的出院发生率。我们计算住院时间（LOHS）和院内死亡率（IHM）。按糖尿病状态分层计算OSR和EVAR的使用情况。多变量分析按年龄、性别、年份、吸烟习惯和合并症进行校正。
2003年至2012年，共识别出115,020例诊断为AAA的出院患者。平均年龄为74.91岁，16.7%的患者患有2型糖尿病。糖尿病患者中因AAA导致的出院率显著增加（2003年为50.09，2012年为每10万人78.23例），非糖尿病患者中也显著增加（从69.24增至78.66）。在所有研究年份中，非糖尿病患者的发生率高于糖尿病患者。两组患者接受EVAR的比例均增加，开放修复比例下降。多变量分析后我们发现，在研究期间LOHS和IHM有所改善，糖尿病患者的IHM低于非糖尿病患者（比值比0.81；95%置信区间0.76 - 0.85）。
非糖尿病患者的发生率更高。糖尿病患者和非糖尿病患者中EVAR的使用均增加，开放修复似乎在减少。2003年至2012年IHM和LOHS有所改善。糖尿病患者的死亡率显著更低。
