Changing Epidemiology of Abdominal Aortic Aneurysms in England and Wales: Older and More Benign?
Background—Recent studies from Australia, New Zealand and Sweden have reported declines in abdominal aortic aneurysm (AAA) incidence, prevalence and mortality. This may have important implications for screening programmes. This study determinedtrendsin AAA incidence and mortalityin England and Wales.
Methods and Results—Cause-specific mortality data for England and Wales were obtained from UK Office for National Statistics; and hospital admissions and procedures data for England were obtained from Hospital Episode Statistics from 2001 to 2009. Poisson regression models were constructed to estimate the relative change over time. Age-standardized rates for AAA mortality in England and Wales fell significantly by 35.7% from 2001 to 2009 and were largely due to a 35.3% drop in age-standardized ruptured AAA deaths. During the same period, ruptured AAA admissions and emergency AAA repairs in England declined by 29.3% and 35.5% respectively. In contrast, non-ruptured AAA admissions have remained static and non-emergency AAA repairs have increased by 17.2%. The average ages for hospital admissions for non-ruptured AAAs and ruptured AAAs have increased by 0.19 years of age per annum (p<0.001) and 0.09 years of age per annum (p<0.001), respectively. Non-ruptured AAA admissions increased by 21.4% in age band 75 years or more but declined by 11.7% in ages less than 75 years.
Conclusions—AAA mortality, ruptured AAA admission and emergency AAA repairhave declined in England and Wales. However non-ruptured AAA admission has remained steady; with increasing rate in older population offsetting a decreasing rate in younger population. This suggests a shift in AAA presentation to the older population. Present screening strategies may need re-assessment toinclude consideration for increasing the age at which to screen men for AAAs.
- Received November 1, 2011.
- Accepted February 17, 2012.
- Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited