RUPTURED ABDOMINAL AORTIC-ANEURYSM - A POPULATION-BASED STUDY

Purpose: The purpose of this study was to make an analysis of all ruptured abdominal aortic aneurysms in a defined population. Methods: An epidemiologic analysis of ruptured abdominal aortic aneurysms (AAAs) was made in an urban population during a 16-year period. The study was retrospective and covered a demographically defined population of 230,000 inhabitants in the city of Malmo, Sweden. Reports of all identified ruptured AAAs in Malmo from 1971 to 1986 were analyzed. The autopsy rate in the city was 85% during this period. Results: Ruptured AAAs were found in 5.6 of 100,000 persons (8.4/100,000 men and 3.0/100,000 women). No increase was found during the study period after age and sex standardization. The age-specific incidence was highest (113/100,000) in men 81 to 90 years old and (68/100,000) in women older than 90. The number of surgical interventions increased among men but not among women and the surgical mortality rate decreased from 86% to 43%. The overall mortality rate for ruptured AAA was 88%. The most common symptoms were abdominal pain and toss of consciousness. Conclusions: The validity of the study was based on a high autopsy rate. The incidence of aneurysm rupture was not tow compared with other Scandinavian studies, but was low in comparison with studies from the United Kingdom. No increase in standardized rupture incidence was found. To substantially decrease the total mortality caused by rupture, operation must be performed before rupture.