• Wei-Ling Chen, Chung-Dann Kan, Yi-Ting Huang, and Hsin-I Shih.
• Department of Biomedical Engineering, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
• J Chin Med Assoc. 2024 Aug 22.

BackgroundAbdominal aortic aneurysm (AAA) poses a considerable global health challenge; however, population-based studies on AAA are scarce. The current study determined the hospitalization rates, surgical trends, mortality, and reintervention rates for ruptured (r-AAA) and nonruptured (nr-AAA) AAA by using a national health insurance database.MethodsWe conducted a population-based retrospective cohort study by analyzing data from 2007 to 2018 from the Taiwanese National Health Insurance Research Database. Individuals over 20 years of age with a new diagnosis of AAA were included in this study.ResultsA total of 70 457 patients were given a diagnosis of aortic aneurysm or dissection over the study period; 22 538 (32%) adult patients (≥20 years) had AAA. The annual incidence of AAA was approximately 7.7 to 10.3 per 100 000 (r-AAA: 0.8-1.3 per 100 000 versus nr-AAA: 6.8-9.0 per 100 000). Most of the patients with AAA were older adults (85%); 15 392 (68%) patients had a documented hospitalization, and 4885 (32%) underwent surgery within 14 days of diagnosis. The percentage of patients receiving endovascular aneurysm repair (EVAR) increased from 28% to 96% over the study period. The long-term survival rates were higher among the patients who underwent open surgical repair (OSR) compared with those of the patients who received EVAR or conservative treatment, regardless of whether they had r-AAA or nr-AAA.ConclusionAAA is more common among older individuals, and the annual standardized incidence indicates a downward trend. Since the introduction of EVAR, the proportion of patients undergoing EVAR has continually increased, whereas that of those undergoing OSR have decreased. Although EVAR and OSR were both associated with lower mortality rates among patients with r-AAA, OSR resulted in better long-term survival outcomes.Copyright © 2024, the Chinese Medical Association.

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