Increasing incidence of aneurysms of the abdominal aorta in The Netherlands.

OBJECTIVES To study the trend in incidence of aneurysms of the abdominal aorta in The Netherlands during the past two decades. SETTING The Dutch population from 1972 to 1992. DESIGN Analysis of all hospital admissions and deaths due to aneurysms of the abdominal aorta. OUTCOME MEASURES Age adjusted and age specific mortality and discharge rates. In-hospital mortality after surgery upon aneurysms of the abdominal aorta. RESULTS From 1972 to 1992 age adjusted mortality from aneurysms of the abdominal aorta rose from 3.1 to 8.1 per 100,000 in men, and from 1.4 to 2.2 in women. Age adjusted discharge rates (alive and dead) for non-ruptured abdominal aortic aneurysms increased from 3.7 to 37.6 per 100,000 in men and from 1.2 to 5.5 in women. For ruptured aneurysms, the age adjusted discharge rates increased from 2.4 to 10.3 per 100,000 in men and from 0.7 to 1.7 in women. Age adjusted in-hospital mortality after surgery upon non-ruptured aneurysms was halved from 13% in 1972 to 7% in 1992, mortality after acute repair upon ruptured aneurysms also decreased from 52% in 1972 to 36% in 1992. CONCLUSIONS There was an impressive increase in the hospital based incidence for aneurysms of the abdominal aorta during the past two decades in The Netherlands. An improved detection rate through ultrasound is probably a major contributor to this increase, but gender differences and the rise in the number of ruptured aneurysms suggest that a real increase in incidence may exist, especially in men. Surgical outcome for both ruptured and non-ruptured aneurysms of the abdominal aorta improved.