Trends in Abdominal Aortic Aneurysm Repair Incidence, Comorbidity, Treatment, and Mortality: A Danish Nationwide Cohort Study, 1996–2018
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Trends in Abdominal Aortic Aneurysm Repair Incidence, Comorbidity, Treatment, and Mortality : A Danish Nationwide Cohort Study, 1996–2018. / Møller, Anders; Eldrup, Nikolaj; Wetterslev, Jørn; Hellemann, Dorthe; Nielsen, Henning Bay; Rostgaard, Klaus; Hjalgrim, Henrik; Pedersen, Ole Birger.
In: Clinical Epidemiology, Vol. 16, 2024, p. 175-189.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Trends in Abdominal Aortic Aneurysm Repair Incidence, Comorbidity, Treatment, and Mortality
T2 - A Danish Nationwide Cohort Study, 1996–2018
AU - Møller, Anders
AU - Eldrup, Nikolaj
AU - Wetterslev, Jørn
AU - Hellemann, Dorthe
AU - Nielsen, Henning Bay
AU - Rostgaard, Klaus
AU - Hjalgrim, Henrik
AU - Pedersen, Ole Birger
N1 - Publisher Copyright: © 2024 Møller et al.
PY - 2024
Y1 - 2024
N2 - Background: Significant changes in Western populations’ abdominal aortic aneurysm (AAA) epidemiology have been reported following the introduction of screening, endovascular AAA repair, and reduced tobacco consumption. We report incidence and mortality of AAA repair in Denmark from 1996 to 2018, where AAA screening was not implemented. Methods: Nationwide cohort study of prospective data from population-based Danish registries covering 1996 to 2018. We identified 15,395 patients undergoing first-time AAA repair using the Danish Vascular Registry. Comorbidity was assessed by Charlson’s Comorbidity Index (CCI). Incidence rate (IR) ratios and mortality rate ratios (MRR) were estimated by multivariable Poisson and Cox regression, respectively. Results: Overall AAA repair IR decreased by 24% from 1996 through 2018, mainly reflecting a 53% IR reduction in ruptured AAA repairs in men. Overall, the IR decreased 52–63% in age groups below 70 years and increased 81% among octogenarians. The proportion of intact AAAs repaired endovascularly increased from 2% in 1996–1999 to 42% in 2015–2018. For both ruptured and intact AAAs the CCI score increased by 0.9% annually independently of age and sex. The adjusted five-year MRR in 2016–2018 vs.1996–2000 was 0.46 (95% confidence interval (CI): 0.39–0.54) following ruptured and 0.51 (95% CI: 0.44–0.59) following intact AAA repair. Conclusion: In Denmark, overall AAA repair incidence decreased between 1996 and 2018, primarily reflecting a reduction among males and a shift to an older population requiring intervention. These trends mirror changes in tobacco consumption in Denmark. Regardless of age and comorbidity, AAA repair mortality decreased markedly during the study period.
AB - Background: Significant changes in Western populations’ abdominal aortic aneurysm (AAA) epidemiology have been reported following the introduction of screening, endovascular AAA repair, and reduced tobacco consumption. We report incidence and mortality of AAA repair in Denmark from 1996 to 2018, where AAA screening was not implemented. Methods: Nationwide cohort study of prospective data from population-based Danish registries covering 1996 to 2018. We identified 15,395 patients undergoing first-time AAA repair using the Danish Vascular Registry. Comorbidity was assessed by Charlson’s Comorbidity Index (CCI). Incidence rate (IR) ratios and mortality rate ratios (MRR) were estimated by multivariable Poisson and Cox regression, respectively. Results: Overall AAA repair IR decreased by 24% from 1996 through 2018, mainly reflecting a 53% IR reduction in ruptured AAA repairs in men. Overall, the IR decreased 52–63% in age groups below 70 years and increased 81% among octogenarians. The proportion of intact AAAs repaired endovascularly increased from 2% in 1996–1999 to 42% in 2015–2018. For both ruptured and intact AAAs the CCI score increased by 0.9% annually independently of age and sex. The adjusted five-year MRR in 2016–2018 vs.1996–2000 was 0.46 (95% confidence interval (CI): 0.39–0.54) following ruptured and 0.51 (95% CI: 0.44–0.59) following intact AAA repair. Conclusion: In Denmark, overall AAA repair incidence decreased between 1996 and 2018, primarily reflecting a reduction among males and a shift to an older population requiring intervention. These trends mirror changes in tobacco consumption in Denmark. Regardless of age and comorbidity, AAA repair mortality decreased markedly during the study period.
KW - Danish National Patient Registry
KW - Danish Vascular Registry
KW - endoluminal repair
KW - open surgery
KW - registries
KW - vascular surgery
U2 - 10.2147/CLEP.S427348
DO - 10.2147/CLEP.S427348
M3 - Journal article
C2 - 38505359
AN - SCOPUS:85188759596
VL - 16
SP - 175
EP - 189
JO - Clinical Epidemiology
JF - Clinical Epidemiology
SN - 1179-1349
ER -
ID: 388785465