Epidemiology and Outcome of Aortic Aneurysms in Hong Kong |
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Authors: | Stephen WK Cheng Albert CW Ting Simon HY Tsang |
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Institution: | (1) Department of Surgery, The University of Hong Kong Medical Centre, Queen Mary Hospital, Pokfulam Road, Hong Kong, China, |
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Abstract: | Abstract
The objective of this study was to determine epidemiology and mortality statistics for abdominal aortic aneurysms (AAAs) in
Hong Kong. Data from three sources were obtained and analyzed: (1) Hong Kong Hospital Authority discharge statistics for 1999
and 2000; (2) a survey on aortic aneurysms in public hospitals conducted by the Working Group of Vascular Surgery; and (3)
the Department of Surgery, University of Hong Kong Medical Center aortic aneurysm database. The disease pattern, distribution,
and operative mortality were determined. The annual incidence of AAA in Hong Kong is 13.7 per 100,000 population and 105 per
100,000 for those aged 65 and above. About 10% of the AAAs that presented were ruptured. The mean age of the AAA patients
was 74 years, with 84% of them over age 65. The operative repair rate for AAAs was low, being only 8% for intact aneurysms
and 54% for ruptured ones. Overall, 45% of all aneurysm repairs were performed for a ruptured AAA. There is diverse practice
between major vascular centers and smaller regional hospitals. The territory-wide operative mortality rates for intact and
ruptured aneurysms were 10% (range 4–24%) and 70% (range 38––100%), respectively. There was no gender bias in the rupture
and operative rates. The overall mortality was 17% for intact AAAs and 78% for ruptured AAAs. The average length of hospital
stay was 19 days for elective AAA surgery and 13 days for ruptured AAAs. The number of operations in high-volume centers is
increasing with a concomitant decrease in operative mortality. There are no definitive data to indicate that the incidence
of AAAs is rising, but a trend toward an increasing number of operations in referral centers is noted. The low repair rates
for intact AAAs and the high proportion of repairs for ruptured aneurysms suggest that AAAs are undertreated in Hong Kong. |
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