Association of Sex with Repair Type and Long-term Mortality in Adults with Abdominal Aortic Aneurysm

Abstract

Importance: Sex-based differences exist in the prevalence and clinical presentation of abdominal aortic aneurysm (AAA). However, it is unclear if sex is associated with AAA repair type and long-term mortality. Objective: To investigate whether a sex-related difference exists in mortality risk after AAA repair owing to differences in repair type. Design, Setting, and Participants: This cohort study uses data from the Vascular Quality Initiative, a national clinical registry, and Medicare claims to investigate endovascular and surgical repair procedures performed between January 1, 2003, and September 30, 2015, in patients aged 65 years or older with AAA. The data were analyzed from October 1, 2018, to November 19, 2019. Exposure: Sex of the patient. Main Outcomes and Measures: Endovascular (EVR) or open surgical AAA repair type and subsequent long-term, all-cause mortality. Results: In this cohort study of 16386 patients, 12757 (77.9%) were men and 3629 (22.1%) were women. Women were more likely than men to be older (mean [SD] age, 77 [6.5] years vs 75 [6.6] years; P