Is the incidence of abdominal aortic aneurysm declining in the 21st century? Mortality and hospital admissions for England & Wales and Scotland

Eur J Vasc Endovasc Surg. 2012 Feb;43(2):161-6. doi: 10.1016/j.ejvs.2011.11.014. Epub 2011 Dec 16.

Abstract

Background: Between 1951 and 1995 there was a steady increase in age-standardised deaths from all aortic aneurysms in men, from 2 to 56 per 100,000 population in England & Wales, supporting an increase in incidence. More recently, evidence from Sweden and elsewhere suggests that now the incidence of abdominal aortic aneurysm (AAA) may be declining.

Methods: National statistics for hospital admissions and deaths from AAA, after population age-standardisation, were used to investigate current trends in England & Wales and Scotland.

Results: Between 1997 and 2009 there has been a reduction in age-adjusted mortality from AAA from 40.4 to 25.7 per 100,000 population for England & Wales and from 30.1 to 20.8 per 100,000 population in Scotland. The decrease in mortality was more marked for men than women. Mortality decreased more than 2-fold in those <75 years versus 25% only in those >75 years. During this same time period the elective hospital admissions for AAA repair have only increased in the population >75 years.

Conclusions: These data suggest that the age at which clinically-relevant aneurysms present has increased by 5-10 years and that incidence of clinically-relevant AAA in men in England & Wales and Scotland is declining rapidly. The reasons for this are unclear.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm, Abdominal / mortality*
  • Aortic Aneurysm, Abdominal / surgery
  • England / epidemiology
  • Female
  • Hospitalization / statistics & numerical data*
  • Hospitalization / trends
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Scotland / epidemiology
  • Sex Factors
  • Vascular Surgical Procedures / statistics & numerical data
  • Vascular Surgical Procedures / trends
  • Wales / epidemiology