Concern over rising aneurysm death rate, study suggests

A study conducted by Harvard Medical School and St George’s University of London and published in the New England Journal of Medicine has raised concern over findings which indicate that the death rate from abdominal aortic aneurysms more than three times higher in England than in the US.

The teams analysed official national data on aneurysms in the US and England between 2005 and 2012. While the data analysed was only from England, the research team believe their findings apply across the UK. It suggested that English surgeons may be performing preventative operations less often.

Surgery becomes necessary when the aorta, which is normally 2 cm across, contains an aneurysm which grows to 5.5 cm in men or 5 cm in women. Surgeons can either perform keyhole surgery to line the aorta with stents or perform open surgery to replace the aneurysm with a graft.

The data showed that the rate of aneurysm repair in England was half that of the US and those that were performed took place when the aneurysm had reached a larger size of 6.37 cm in England.

In an interview with the BBC, Dr Alan Karthikesalingam, from St George's, told the BBC News website: "This is not something we knew was happening.

"From an English perspective it raises a series of questions about what we do in response."

He was clear that the study is not definitive proof that doctors in England have got it wrong, but that there ‘may be room for improvement’.

He said: "It is a concerning observation. The problem is our study does not conclusively prove that the lower operation rate in England is the only cause of the higher number of aneurysm deaths."

The Vascular Society of Great Britain and Ireland commented: "Further trials are required to determine the safe threshold for abdominal aortic aneurysm management in the UK."

http://www.bbc.co.uk/news/health-38077265