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Home > Press Center > Press Releases from 2005 Annual Meeting > Women likelier than men to die after aneurysm repair procedures

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Jill Goodwin
Director of Communications
312-334-2308

Women have a greater risk of dying after open surgeries or endovascular repair procedures (EVAR) to repair abdominal aortic aneurysms (AAA), and are less likely than men to return home after either repair, according to research presented at the annual meeting of the Society for Vascular Surgery in Chicago.  They are also less likely than men to undergo surgery when having a ruptured aneurysm and those women who do have surgery have a higher death rate than men.   Researchers led by Dr. Ellen D. Dillavou, University of Pittsburgh Medical Center, Pittsburgh, Penn., identified three significant predictors of elective and ruptured AAA repair mortality: increased age, female sex, and open surgery versus EVAR.

This is the first nationwide review of women undergoing aortic aneurysm surgery. Researchers analyzed 16,125 inpatient hospital Medicare records from 1994 to 2001 to determine whether gender differences exist, and to what extent. Women stayed in the hospital longer than men, and had higher hospital charges. The average length of stay for elective AAA repairs in 2003 was 6.9 days for men and 8.9 days for women. Average hospital charges during that time were $61,644 for men and $70,117 for women. Also using 2003 data, men were more likely than women to be discharged home after rupture (32.9 percent vs. 23.3 percent) and elective repair (84.5 percent men vs. 70.1 percent women).

The number of Medicare recipients over age 65 undergoing elective AAA between 1994 to 2003 dropped from 87.4 to 77.2 repairs per 100,000 Medicare recipients, respectively. During that time EVAR became available, replacing open surgery rather than adding to the total number of elective AAA repairs. Improvements in AAA management have reduced the incidence of aneurysm ruptures with a lower utilization of services. Rupture repairs from 1994 to 2003 decreased by 29 percent for men, and 12 percent for women.  Although the overall rates of rupture mortality have not changed, they were significantly higher for women (52.8 percent) than for men (44.2 percent). From 1994 to 2003, mortality for elective AAA repair decreased from 5.57 percent to 3.20 percent in men, and from 7.48 percent to 5.45 percent in women.

The aorta, which carries blood away from the heart, is the body’s largest artery. An aortic aneurysm occurs when a weak area of the abdominal aorta expands or bulges, due to pressure from blood flowing through. Two treatments for AAA include surgical, called open aneurysm repair, which involves making an incision in the abdomen; and endovascular stent graft, a less invasive procedure which involves making an incision in the groin and then threading a stent through blood vessels to repair the aneurysm. Women are less likely than men to have a stent graft due to smaller arteries overall.

A normal aorta is about 1 inch in diameter; elective surgery generally occurs when the aorta expands to 2 inches. A ruptured aneurysm causes severe internal bleeding, and is usually fatal. Annually, about 200,000 people in the United States are diagnosed with AAA. Of those, some 15,000 cases are threatening enough to cause death if the aneurysm is left untreated.