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Epidemiology of Abdominal Aortic Aneurysm Repair in Brazil from 2008 to 2019 and Comprehensive Review of Nationwide Statistics Across the World

  • Surgery in Low and Middle Income Countries
  • Published:
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Abstract

Introduction

Studying epidemiology of abdominal aortic aneurysms repairs is essential to prevent related deaths. Although outcomes are influenced by socioeconomic factors, there are no nationwide studies on these statistics in low-and-middle income countries. Therefore, we designed this study to evaluate abdominal aortic aneurysms repair rates, trends, costs, and in-hospital mortality in the Brazilian Public Health System, which exclusively insures over 160 million Brazilians.

Material and Methods

Retrospective cross-sectional population-based analysis of publicly available data referring to all abdominal aortic aneurysm repairs performed between 2008 and 2019 in Brazilian public hospitals.

Results

We observed a total of 13,506 abdominal aortic aneurysm repairs, of which 32% were emergency endovascular repairs, 20% emergency open repairs, 32% elective endovascular repairs and 16% elective open repairs. There has been a downward trend in total abdominal aortic aneurysms repairs and an increasing predominance of endovascular repair. Elective and endovascular repairs were significantly associated with lower in-hospital mortality. For ruptured abdominal aortic aneurysms, we observed mortality rates of 13.8% after endovascular repair and 52.1% after open repair. For intact abdominal aortic aneurysms, we observed mortalities of 3.8% after endovascular repair and 18.6% after open repair. Procedure and mortality rates varied significantly among the Brazilian regions.

Conclusions

We observed a low and decreasing rate of abdominal aortic aneurysm repair. Most repairs were emergency and endovascular and there was an increasing predominance of endovascular repair. Endovascular and elective repairs were associated with lower mortality.

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Acknowledgements

We thank Rogerio Ruscitto do Prado, PhD, for his statistical consultation.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Vascular and Endovascular Surgery Division, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, Bloco A1, sala 423 Morumbi, São Paulo, 05652-900, Brazil

    Andressa Cristina Sposato Louzada, Marcelo Fiorelli Alexandrino da Silva, Maria Fernanda Cassino Portugal, Edson Amaro, Marcelo Passos Teivelis & Nelson Wolosker

  2. Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), Hospital Israelita Albert Einstein, Av. Prof. Francisco Morato, 4293, São Paulo, 05521-200, Brazil

    Nickolas Stabellini, Marcelo Passos Teivelis & Nelson Wolosker

  3. Faculdade de Medicina da, Universidade de São Paulo (FMUSP), Av. Dr. Arnaldo, 455, São Paulo, 01246-903, Brazil

    Antonio Eduardo Zerati, Edson Amaro & Nelson Wolosker

Authors
  1. Andressa Cristina Sposato Louzada
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  2. Marcelo Fiorelli Alexandrino da Silva
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  3. Maria Fernanda Cassino Portugal
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Corresponding author

Correspondence to Andressa Cristina Sposato Louzada.

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No author has conflict of interest in this manuscript.

Ethical Approval

The Ethics Committee of the Hospital Israelita Albert Einstein approved the study (CAAE 35826320.2.0000.0071). Since we used a publicly available database with de-identified entries, a waiver of informed consent forms was requested and granted.

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Louzada, A.C.S., da Silva, M.F.A., Portugal, M.F.C. et al. Epidemiology of Abdominal Aortic Aneurysm Repair in Brazil from 2008 to 2019 and Comprehensive Review of Nationwide Statistics Across the World. World J Surg 46, 1485–1492 (2022). https://doi.org/10.1007/s00268-022-06486-0

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