Abstract
Background
The aim of this study was to assess possible differences in mortality between men and women with an abdominal aortic aneurysm (AAA) treated either by elective repair or following aneurysm rupture.
Methods
A systematic literature search was performed using the MEDLINE, Cochrane and Embase databases. Data were analysed by means of bivariate random-effects meta-analysis. Data were pooled and odds ratios (ORs) calculated for women compared with men.
Results
Sixty-one studies (516 118 patients) met the predetermined inclusion criteria. Twenty-six reported on elective open AAA repair, 21 on elective endovascular repair, 25 on open repair for ruptured AAA and one study on endovascular repair for ruptured AAA. Mortality rates for women compared with men were 7ยท6 versus 5ยท1 per cent (OR 1ยท28, 95 per cent confidence interval (c.i.) 1ยท09 to 1ยท49) for elective open repair, 2ยท9 versus 1ยท5 per cent (OR 2ยท41, 95 per cent c.i. 1ยท14 to 5ยท15) for elective endovascular repair, and 61ยท8 versus 42ยท2 per cent (OR 1ยท16, 95 per cent c.i. 0ยท97 to 1ยท37) in the group that had open repair for rupture. The group that had endovascular repair for ruptured AAA was too small for meaningful analysis.
Conclusion
Women with an AAA had a higher mortality rate following elective open and endovascular repair.