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International guidelines recommend intervention for specific AAA size thresholds, but these are based on historical trials with limited female representation. We aimed to analyse disease characteristics, AAA size at rupture, and intervention outcomes in patients with ruptured AAA from 2009 to 2023 to investigate the gap between guidelines and local realities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-centre retrospective cohort study analysed electronic health records of patients treated for a ruptured AAA, excluding those who were managed palliatively. The study assessed patients\u2019 demographics, risk factors, comorbidities, clinical presentation, radiological characteristics, and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 164 patients (41 females, 123 males, median age 73.5), 93.3% presented with abdominal or back pain. The median AAA size at rupture was 8.0\u00a0cm in males and 7.6\u00a0cm in females. No significant correlations were found between demographic characteristics, risk factors, AAA size, repair modality, and outcomes. Trends show a decline in AAA prevalence and rupture rates, aligning with global health initiatives. Post-intervention survival rates at 30 days were 70.7% (67.5% in males and 80.0% in females), and at 2 years were 65.85% (61.7% in males and 70.0% in females).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Evolving AAA trends and improved post-intervention survival rates warrant a critical reassessment of existing intervention recommendations. Adjusting intervention thresholds to larger sizes may be justified to optimise the risk-benefit ratio.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00423-024-03441-6","type":"journal-article","created":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T01:01:56Z","timestamp":1724115716000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Ruptured AAA: bridging the gap between international guidelines and local clinical realities"],"prefix":"10.1007","volume":"409","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6185-9906","authenticated-orcid":false,"given":"Summer","family":"Hassan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taylor","family":"Frost","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Russell","family":"Bourchier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,8,20]]},"reference":[{"issue":"3","key":"3441_CR1","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1016\/j.ejvs.2015.05.004","volume":"50","author":"SS Bahia","year":"2015","unstructured":"Bahia SS, Holt PJ, Jackson D, Patterson BO, Hinchliffe RJ, Thompson MM, Karthikesalingam A (2015) Systematic review and Meta-analysis of long-term survival after Elective Infrarenal Abdominal aortic aneurysm repair 1969\u20132011: 5 year survival remains poor despite advances in Medical Care and Treatment strategies. 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National Institute for Health and Care Excellence (NICE), London, p 32407032"}],"container-title":["Langenbeck's Archives of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00423-024-03441-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00423-024-03441-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00423-024-03441-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T03:45:29Z","timestamp":1724298329000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00423-024-03441-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,20]]},"references-count":42,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3441"],"URL":"https:\/\/doi.org\/10.1007\/s00423-024-03441-6","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-4705623\/v1","asserted-by":"object"}]},"ISSN":["1435-2451"],"issn-type":[{"value":"1435-2451","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,20]]},"assertion":[{"value":"8 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 August 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 August 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study qualifies as an audit-related activity and was approved by the Vascular Surgery Department at Auckland City Hospital, with approval reference number. Patient confidentiality and data security were strictly maintained throughout the study. Written informed consent from participants was not required as this study was granted an exemption by the Vascular Surgery Department at Auckland City Hospital.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statement of ethics"}},{"value":"The authors have no conflicts of interest to declare.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"256"}}