von Beckerath Olga, Schrader Sebastian, Katoh Marcus, Luther Bernd, Santosa Frans, Kröger Knut
1 Department of Vascular Medicine, HELIOS Klinikum Krefeld, Krefeld, Germany.
2 Department of Radiology, HELIOS Klinikum Krefeld, Krefeld, Germany.
Vasa. 2018 Jan;47(1):43-48. doi: 10.1024/0301-1526/a000667. Epub 2017 Oct 16.
We analysed trends in mortality of endovascular (EVAR) and open aortic repair (OAR) in patients hospitalized for abdominal aortic aneurysms (AAA) in Germany from 2005 to 2015.
We used national statistics published by the Federal Statistical Office in Germany to calculate mortality rate of patients hospitalized with ruptured (rAAA, n = 2,448 in 2005, n = 2,180 in 2015) and non-ruptured (iAAA, n = 11,626 in 2005, n = 14,205 in 2015) AAA.
Considering only those who were treated with EVAR or OAR, treatment rates of iAAA with EVAR increased to 78.2 % in males and 72.6 % in females in 2015 and treatment rates of rAAA to 36.9 % and 40.7 %, respectively. In cases with iAAA, death rates associated with EVAR decreased in males from 2.1 to 1.1 % (p = 0.0005) in the period from 2005 to 2015 but not in females (1.8 % in 2005 and 2.3 % in 2015, p = 0.8511). Similar trends are seen in cases with rAAA (males 30.1 % and 24 %, p = 0.1034, females 36.4 to 37.3 %, p = 0.8511). Death rates associated with OAR increased in males from 4.7 % in 2005 to 5.7 % in 2015 (p = 0.0103) and tended to increase in females from 6.8 to 8.2 % (p = 0.1476). In cases of rAAA, there were no changes. EVAR treatment rates increased in cases with iAAA in both genders with age, as well as in males with rAAA, but not in females. OAR associated death rates increased with age in rAAA (from around 30 % in the sixth/seventh decade of life to almost 80 % in cases with patients over the age of 90) and in iAAA (from 1.1 to 20 %).
The general increase in EVAR procedures in males and females hospitalized for rAAA and iAAA went along with a decrease in in-hospital mortality in males treated with EVAR for iAAA only and an increasing mortality in males treated with OAR for iAAA.
我们分析了2005年至2015年期间在德国因腹主动脉瘤（AAA）住院患者的血管内修复术（EVAR）和开放性主动脉修复术（OAR）的死亡率趋势。
我们使用德国联邦统计局公布的全国统计数据来计算因破裂性（rAAA，2005年n = 2448，2015年n = 2180）和非破裂性（iAAA，2005年n = 11626，2015年n = 14205）AAA住院患者的死亡率。
仅考虑接受EVAR或OAR治疗的患者，2015年iAAA接受EVAR治疗的比例在男性中升至78.2%，女性中升至72.6%；rAAA接受EVAR治疗的比例分别为36.9%和40.7%。在iAAA病例中，2005年至2015年期间与EVAR相关的男性死亡率从2.1%降至1.1%（p = 0.0005），但女性未下降（2005年为1.8%，2015年为2.3%，p = 0.8511）。rAAA病例也有类似趋势（男性从30.1%降至24%，p = 0.1034，女性从36.4%升至37.3%，p = 0.8511）。与OAR相关的男性死亡率从2005年的4.7%升至2015年的5.7%（p = 0.0103），女性有从6.8%升至8.2%的趋势（p = 0.1476）。在rAAA病例中，无变化。iAAA病例中，无论男女，EVAR治疗率均随年龄增加，rAAA男性患者也是如此，但女性并非如此。rAAA和iAAA中，与OAR相关的死亡率均随年龄增加（rAAA从60/70岁时的约30%升至90岁以上患者的近80%，iAAA从1.1%升至20%）。
因rAAA和iAAA住院的男性和女性中EVAR手术总体增加，仅iAAA接受EVAR治疗的男性住院死亡率下降，而iAAA接受OAR治疗的男性死亡率上升。
