腹主动脉瘤患者的发病率、治疗和死亡率。
Incidence, Treatment and Mortality in Patients with Abdominal Aortic Aneurysms.
机构信息
Department of Vascular and Endovascular Surgery/Vascular Center, Klinikum rechts der Isar, Technical University of Munich; Department of Statistics, Ludwig-Maximilians-University Munich.
出版信息
Dtsch Arztebl Int. 2017 Jun 5;114(22-23):391-398. doi: 10.3238/arztebl.2017.0391.
BACKGROUND
Aim of this study was to analyze hospital incidence, type of treatment, and hospital mortality rates of patients with abdominal aortic aneurysm (AAA) in Germany from 2005 to 2014.
METHODS
Microdata of the diagnosis-related group (DRG) statistics compiled by the German Federal Statistical Office for the years 2005-2014 were analyzed. Patients who were hospitalized for a ruptured AAA (rAAA, ICD-10 code I71.3, treated either surgically or conservatively) or received surgical treatment for an unruptured AAA (nrAAA, ICD-10-Code I71.4, treated either with open surgery or an endovascular procedure) were included in the analysis. The "European Standard Population 2013" was used for direct standardization of the hospital incidences. In-hospital mortality was calculated with standardization for age and risk.
RESULTS
The standardized overall hospital incidence of AAA was 27.9 and 3.3 cases per 100 000 people for men and women, respectively; over the period of the study, the incidence of rAAA fell by 30% in both sexes and that of nrAAA rose by 16% in men and 42% in women. The percentage of patients receiving endovascular treatment rose from 29% to 75% in patients with nrAAA and from 8% to 36% in patients with rAAA. The age- and risk-standardized in-hospital mortality of nrAAA was 3.3% in men and 5.3% in women. The in-hospital mortality of surgically treated rAAA was 39% in men and 48% in women.
CONCLUSION
The hospital incidence of AAA rose from 2005 to 2014, while that of rAAA fell. Endovascular treatment became more common for nrAAA as well as rAAA, and in-hospital mortality fell for both.
背景
本研究旨在分析 2005 年至 2014 年德国腹主动脉瘤（AAA）患者的住院发生率、治疗类型和住院死亡率。
方法
分析了德国联邦统计局 2005-2014 年按诊断相关组（DRG）编制的微观数据。本研究纳入了因破裂性腹主动脉瘤（rAAA，ICD-10 编码 I71.3，接受手术或保守治疗）住院或因未破裂性腹主动脉瘤（nrAAA，ICD-10 编码 I71.4，接受开放手术或血管内治疗）接受手术治疗的患者。采用“2013 年欧洲标准人口”对住院发生率进行直接标准化。采用标准化年龄和风险计算住院死亡率。
结果
男性和女性的 AAA 总住院发生率分别为 27.9 和 3.3 例/10 万人；研究期间，男女 rAAA 的发生率分别下降了 30%，nrAAA 的发生率分别上升了 16%和 42%。nrAAA 患者接受血管内治疗的比例从 29%上升到 75%，rAAA 患者从 8%上升到 36%。nrAAA 患者的年龄和风险标准化住院死亡率为男性 3.3%，女性 5.3%。rAAA 患者手术治疗的住院死亡率为男性 39%，女性 48%。
结论
2005 年至 2014 年，AAA 的住院发生率上升，而 rAAA 的住院发生率下降。nrAAA 和 rAAA 患者中血管内治疗更为常见，住院死亡率均有所下降。
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