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Abdominal aortic aneurysm disease in New Zealand: epidemiology and burden between 2002 and 2006.

BACKGROUND
Abdominal aortic aneurysm (AAA) rupture has a high mortality. Four randomised controlled trials indicate significant mortality benefit from population screening for AAA. There is a lack of information on the epidemiology and burden of AAA disease in New Zealand, necessary to support policy in this area.


METHODS
A retrospective analysis was conducted on a dataset consisting of all AAA deaths and all hospital discharges with a AAA diagnosis between 2002 and 2006. Analysis by age, sex, ethnicity, and operative status was performed.


RESULTS
On average, there were 267 elective repairs and 87 emergency repairs annually between 2002 and 2006. The operative mortality rate was 35.2% for emergency repair, and 6.7% for elective repair. There were about 236 known AAA-related deaths annually. Ninety-four percent of AAA deaths between 2002-2006 occurred in individuals >65 years. The case fatality for females was higher than males across every age group. The standardised mortality rate in Maori was twice as high as New Zealand Europeans.


CONCLUSIONS
This study provides essential information to evaluate the appropriateness and feasibility of AAA screening here. A population-based prevalence study is recommended, along with further investigation of high case fatality in females and high mortality in Maori.