{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T00:26:49Z","timestamp":1782520009600,"version":"3.54.5"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2017,12,21]],"date-time":"2017-12-21T00:00:00Z","timestamp":1513814400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2017,12,21]],"date-time":"2017-12-21T00:00:00Z","timestamp":1513814400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We sought to describe and analyze discrepancies between sexes in the outcomes of patients hospitalized for ruptured abdominal aortic aneurysms (rAAA) by conducting a retrospective analysis of the Nationwide Inpatient Sample. The review included all adult patients (\u226518 years old) hospitalized with a primary diagnosis of rAAA between January 2002 and December 2014. In-hospital mortality differences between females and males were analyzed overall and separately among those receiving endovascular AAA repair (EVAR) or open AAA repair (OAR). In-hospital mortality for females declined from 61.0% in 2002 to 49.0% in 2014 (P for trend &lt;0.001), while mortality for males declined from 48.6% in 2002 to 32.2% in 2014 (P for trend &lt;0.001). Among those receiving EVAR, females were significantly more likely to die in the hospital than males (adjusted odds ratio [OR], 1.44; 95% CI, 1.12\u20131.84). In addition, the odds of mortality among those receiving OAR were higher for females than males (adjusted OR, 1.14; 95% CI: 1.00\u20131.31). These data provide evidence that despite overall decreasing trends in mortality for both sexes, females remain at higher risk of death compared with males regardless of surgical repair procedure.<\/jats:p>","DOI":"10.1038\/s41598-017-18451-2","type":"journal-article","created":{"date-parts":[[2017,12,15]],"date-time":"2017-12-15T12:07:27Z","timestamp":1513339647000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Persisting disparities between sexes in outcomes of ruptured abdominal aortic aneurysm hospitalizations"],"prefix":"10.1038","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9646-1781","authenticated-orcid":false,"given":"Mark","family":"Stuntz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9line","family":"Audibert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2017,12,21]]},"reference":[{"key":"18451_CR1","doi-asserted-by":"publisher","first-page":"1425","DOI":"10.1001\/archinte.160.10.1425","volume":"160","author":"FA Lederle","year":"2000","unstructured":"Lederle, F. A. et al. The aneurysm detection and management study screening program: validation cohort and final results. Aneurysm Detection and Management Veterans Affairs Cooperative Study. Arch. Intern. Med. \n                           160, 1425\u20131430 (2000).","journal-title":"Arch. Intern. Med."},{"key":"18451_CR2","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1067\/mva.2001.115275","volume":"34","author":"FA Lederle","year":"2001","unstructured":"Lederle, F. A., Johnson, G. R. & Wilson, S. E. Abdominal aortic aneurysm in women. J. Vasc. Surg. \n                           34, 122\u2013126 (2001).","journal-title":"J. Vasc. Surg."},{"key":"18451_CR3","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1016\/j.jvs.2008.12.008","volume":"49","author":"ES Lee","year":"2009","unstructured":"Lee, E. S., Pickett, E., Hedayati, N., Dawson, D. L. & Pevec, W. C. Implementation of an aortic screening program in clinical practice: implications for the Screen for Abdominal Aortic Aneurysms Very Efficiently (SAAAVE) Act. J. Vasc. Surg. \n                           49, 1107\u20131111 (2009).","journal-title":"J. Vasc. Surg."},{"key":"18451_CR4","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/j.yasu.2013.03.004","volume":"47","author":"AM Lee","year":"2013","unstructured":"Lee, A. M. & Chaikof, E. L. Is the abdominal aortic aneurysm rupture rate decreasing? Adv. Surg. \n                           47, 271\u2013286 (2013).","journal-title":"Adv. Surg."},{"key":"18451_CR5","doi-asserted-by":"publisher","first-page":"1405","DOI":"10.1002\/bjs.9235","volume":"100","author":"JJ Reimerink","year":"2013","unstructured":"Reimerink, J. J., van der Laan, M. J., Balm, R. & Legemate, D. A. Systematic review and meta-analysis of population-based mortality from ruptured abdominal aortic aneurysm. Br. J. Surg. \n                           100, 1405\u20131413 (2013).","journal-title":"Br. J. Surg."},{"key":"18451_CR6","doi-asserted-by":"publisher","first-page":"1512","DOI":"10.1016\/j.jvs.2014.01.007","volume":"59","author":"A Dua","year":"2014","unstructured":"Dua, A., Kuy, S., Lee, C. J., Upchurch, G. R. Jr. & Desai, S. S. Epidemiology of aortic aneurysm repair in the United States from 2000 to 2010. J. Vasc. Surg. \n                           59, 1512\u20131517 (2014).","journal-title":"J. Vasc. Surg."},{"key":"18451_CR7","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1016\/j.jvs.2012.11.039","volume":"57","author":"RC Lo","year":"2013","unstructured":"Lo, R. C. et al. Vascular Study Group of New England. Gender differences in abdominal aortic aneurysm presentation, repair, and mortality in the Vascular Study Group of New England. J. Vasc. Surg. \n                           57, 1261\u20131268 (2013).","journal-title":"J. Vasc. Surg."},{"key":"18451_CR8","doi-asserted-by":"publisher","first-page":"9S","DOI":"10.1016\/j.jvs.2009.10.129","volume":"51","author":"L Mureebe","year":"2010","unstructured":"Mureebe, L., Egorova, N., McKinsey, J. F. & Kent, K. C. Gender trends in the repair of ruptured abdominal aortic aneurysms and outcomes. J. Vasc. Surg. \n                           51, 9S\u201313S (2010).","journal-title":"J. Vasc. Surg."},{"key":"18451_CR9","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1002\/bjs.7134","volume":"97","author":"N Grootenboer","year":"2010","unstructured":"Grootenboer, N. et al. Systematic review and meta-analysis of sex differences in outcome after intervention for abdominal aortic aneurysm. Br. J. Surg. \n                           97, 1169\u20131179 (2010).","journal-title":"Br. J. Surg."},{"key":"18451_CR10","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1016\/j.jvs.2003.10.064","volume":"39","author":"AD Dueck","year":"2004","unstructured":"Dueck, A. D., Johnston, K. W., Alter, D., Laupacis, A. & Kucey, D. S. Predictors of repair and effect of gender on treatment of ruptured abdominal aortic aneurysm. J. Vasc. Surg. \n                           39, 784\u2013787 (2004).","journal-title":"J. Vasc. Surg."},{"key":"18451_CR11","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1046\/j.1365-2168.2000.01346.x","volume":"87","author":"JB Semmens","year":"2000","unstructured":"Semmens, J. B., Norman, P. E., Lawrence-Brown, M. M. D. & Holman, C. D. A. Influence of gender on outcome from ruptured abdominal aortic aneurysm. Br. J. Surg. \n                           87, 191\u2013194 (2000).","journal-title":"Br. J. Surg."},{"key":"18451_CR12","doi-asserted-by":"publisher","first-page":"1096","DOI":"10.1002\/bjs.5784","volume":"94","author":"M Filipovic","year":"2007","unstructured":"Filipovic, M., Seagroatt, V. & Goldacre, M. J. Differences between women and men in surgical treatment and case fatality rates for ruptured aortic abdominal aneurysm in England. Br. J. Surg. \n                           94, 1096\u20131099 (2007).","journal-title":"Br. J. Surg."},{"key":"18451_CR13","doi-asserted-by":"publisher","first-page":"3S","DOI":"10.1016\/j.jvs.2012.08.125","volume":"57","author":"JE Starr","year":"2013","unstructured":"Starr, J. E. & Halpern, V. Abdominal aortic aneurysms in women. J. Vasc. Surg. \n                           57, 3S\u201310S (2013).","journal-title":"J. Vasc. Surg."},{"key":"18451_CR14","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1016\/j.jvs.2005.09.043","volume":"43","author":"ED Dillavou","year":"2006","unstructured":"Dillavou, E. D., Muluk, S. C. & Makaroun, M. S. A decade of change in abdominal aortic aneurysm repair in the United States: have we improved outcomes equally between men and women? J. Vasc. Surg. \n                           43, 230\u2013238 (2006).","journal-title":"J. Vasc. Surg."},{"key":"18451_CR15","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1016\/j.jvs.2007.01.043","volume":"45","author":"JT McPhee","year":"2007","unstructured":"McPhee, J. T., Hill, J. S. & Eslami, M. H. The impact of gender on presentation, therapy, and mortality of abdominal aortic aneurysm in the United States, 2001\u20132004. J. Vasc. Surg. \n                           45, 891\u2013899 (2007).","journal-title":"J. Vasc. Surg."},{"key":"18451_CR16","unstructured":"National Inpatient Sample (NIS). Healthcare Cost and Utilization Project (HCUP). Agency for healthcare research and quality. Rockville, MD (2002\u20132014)."},{"key":"18451_CR17","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1016\/j.jvs.2013.08.093","volume":"59","author":"ST Edwards","year":"2014","unstructured":"Edwards, S. T. et al. Comparative effectiveness of endovascular versus open repair of ruptured abdominal aortic aneurysm in the Medicare population. J. Vasc. Surg. \n                           59, 575\u2013582 (2014).","journal-title":"J. Vasc. Surg."},{"key":"18451_CR18","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1097\/00005650-199801000-00004","volume":"36","author":"A Elixhauser","year":"1998","unstructured":"Elixhauser, A., Steiner, C., Harris, D. R. & Coffey, R. M. Comorbidity measures for use with administrative data. Med. Care. \n                           36, 8\u201327 (1998).","journal-title":"Med. Care."},{"key":"18451_CR19","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1097\/MLR.0b013e31819432e5","volume":"47","author":"C van Walraven","year":"2009","unstructured":"van Walraven, C., Austin, P. C., Jennings, A., Quan, H. & Forster, A. J. A modification of the Elixhauser comorbidity measures into a point system for hospital death using administrative data. Med. Care. \n                           47, 626\u2013633 (2009).","journal-title":"Med. Care."},{"key":"18451_CR20","unstructured":"U.S. Census Bureau, Population Division. American FactFinder. Annual Estimates of the Resident Population. Available from: http:\/\/factfinder2.census.gov."},{"key":"18451_CR21","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1097\/NNR.0b013e3182533403","volume":"61","author":"J Saylor","year":"2012","unstructured":"Saylor, J., Friedmann, E. & Lee, H. J. Navigating complex sample analysis using national survey data. Nurs. Res. \n                           61, 231\u2013237 (2012).","journal-title":"Nurs. Res."},{"key":"18451_CR22","doi-asserted-by":"publisher","first-page":"838","DOI":"10.1001\/jamasurg.2016.0782","volume":"151","author":"CW Hicks","year":"2016","unstructured":"Hicks, C. W. et al. Comprehensive assessment of factors associated with in-hospital mortality after elective abdominal aortic aneurysm repair. JAMA Surg. \n                           151, 838\u2013845 (2016).","journal-title":"JAMA Surg."},{"key":"18451_CR23","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1093\/aje\/kwp440","volume":"171","author":"GS Bieler","year":"2010","unstructured":"Bieler, G. S., Brown, G. G., Williams, R. L. & Brogan, D. J. Estimating model-adjusted risks, risk differences, and risk ratios from complex survey data. Am. J. Epidemiol. \n                           171, 618\u2013623 (2010).","journal-title":"Am. J. Epidemiol."},{"key":"18451_CR24","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1016\/j.jvs.2015.10.087","volume":"63","author":"RC Lo","year":"2016","unstructured":"Lo, R. C. & Schermerhorn, M. L. Abdominal aortic aneurysms in women. J. Vasc. Surg. \n                           63, 839\u2013844 (2016).","journal-title":"J. Vasc. Surg."},{"key":"18451_CR25","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1159\/000446871","volume":"135","author":"M Stuntz","year":"2016","unstructured":"Stuntz, M. Modeling the burden of abdominal aortic aneurysm in the USA in 2013. Cardiology. \n                           135, 127\u2013131 (2016).","journal-title":"Cardiology."},{"key":"18451_CR26","unstructured":"Draft Research Plan: Abdominal Aortic Aneurysm: Primary Care Screening. U.S. Preventive Services Task Force. August 2017. Available from: https:\/\/www.uspreventiveservicestaskforce.org\/Page\/Document\/draft-research-plan\/abdominal-aortic-aneurysm-primary-care-screening."},{"key":"18451_CR27","doi-asserted-by":"publisher","first-page":"h825","DOI":"10.1136\/bmj.h825","volume":"350","author":"M Johansson","year":"2015","unstructured":"Johansson, M., Hansson, A. & Brodersen, J. Estimating overdiagnosis in screening for abdominal aortic aneurysm: could a change in smoking habits and lowered aortic diameter tip the balance of screening towards harm? BMJ. \n                           350, h825 (2015).","journal-title":"BMJ."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-017-18451-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-017-18451-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-017-18451-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T17:15:10Z","timestamp":1671815710000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-017-18451-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,21]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2017,12]]}},"alternative-id":["18451"],"URL":"https:\/\/doi.org\/10.1038\/s41598-017-18451-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,21]]},"assertion":[{"value":"20 October 2017","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 December 2017","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 December 2017","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare that they have no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"17994"}}