| Summary: | 碩士 === 高雄醫學大學 === 藥學系臨床藥學碩士班 === 103 === Background: Aortic aneurysm (AA) is a leading cause of death in most countries. The prevalence of abdominal aortic aneurysm (AAA) has been reported in Western countries is around 1.3-8%. It’s still unclear about the incidence, prevalence and outcome of AA for all subtypes in general population. On the other hand, the effectiveness of medical therapy for AA remained controversial. The evidences are still weak, especially for patients who receive operation for aortic aneurysm.
Study aim: The objective of this study is to investigate the epidemiology of AA in Taiwan by both incidence and prevalence, as well as to evaluate the prescribing patterns. In addition, we evaluated the outcomes of patients who received operation for AA, and also find the association between medication use and outcome.
Methods: The study is divided into two parts. The first part is an epidemiological study to calculate the incidence, prevalence and mortality of AA in Taiwan between 2005 and 2011. The second part is a population-based cohort study. We identified patients who having the diagnosis of AA and also receiving operation between January 1, 2005 and December 31, 2010. Baseline characteristics, disease information, prescribing pattern were all assessed. The endpoints included all-cause death, AA-related re-hospitalization and re-operation. The association between medication use and outcome for patients received operation was evaluated by cox regression.
Results: The epidemiology research shows that the incidence of AA in Taiwan increased in recent years. The average annual incidence of AA in Taiwan is 7.35 per 100,000 people, and the prevalence is 29.04 per 100,000 people. The incidence is associated with both gender and age difference. It’s much higher in those who aged above 65 years, especially for male population.
In the second part of this study, we included 1936 operated AA patients during 2005-2010, 1633 of them survived more than 30 days. Among the 1633 patients, we found that both of aspirin and statin significantly decrease the all-cause mortality (Aspirin: HR:0.422, CI:0.314-0.566; Statin: HR:0.279, CI:0.175-0.444).
Conclusion: It shows an increased trend of AA for incidence, prevalence and mortality during 2005-2011. Prescribing aspirin and statin after AA surgery could decrease the all-cause mortality significantly, but was no significant benefit for re-operation and re-hospitalization.
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