Researchers have found that patients in the USA who suffer from a ruptured aortic aneurysm which is a catastrophic bleeding from a diseased weakening of the body’s largest artery are 13 per cent less likely to die than those in the UK.
They also found they also found that patients in both countries stood a better chance of undergoing surgery, and therefore survival, if they were treated on a weekday.
The condition is called a ruptured abdominal aortic aneurysm which affects particularly men aged more than 65.
The aorta is the main blood vessel that supplies blood to the body, from the heart through the chest and abdomen, and in some people, its lining or wall can become weakened.
It may then expand and bulge which is called abdominal aortic aneurysm (AAA) which can itself rupture. In England approximately 45 individuals per 100 000 population die as a result.
The new study in The Lancet shows that the chance of surviving a hospital stay for a ruptured AAA appears to be higher in the USA than in England.
The findings suggest that American patients benefit from more active treatment, with US hospitals over a third (38%) more likely to offer surgical treatment, resulting in 13% less deaths from ruptured AAA compared with English hospitals.
“The large mortality difference is concerning”, says author Peter Holt, of the Vascular Institute, at St George’s, University of London. He added: “Our data suggest that failure to deliver proven life-saving surgery is a key reason why in-hospital survival for patients with ruptured AAA is lower in England.
“In particular, increased use of a less invasive procedure known as endovascular aneurysm repair could save more lives and help to close the mortality gap.
“Our findings reinforce concerns that patients are less likely to receive optimal care in English NHS hospitals if they are admitted for emergency conditions on a weekend, but show that the challenge of providing high-quality out-of-hours care is not just confined to England.”
Using national administrative data from the Hospital Episode Statistics (HES) for England and the representative Nationwide Inpatient Sample for the USA, the researchers compared survival for 11,799 patients admitted to hospital with ruptured AAA in England and 23,838 patients in the USA, between 2005 and 2010.
Importantly, they also found that patients in both countries stood a better chance of undergoing surgery, and therefore survival, if they were treated on a weekday and that patients treated in teaching hospitals with larger bed capacities and performing a greater number of ruptured AAA cases each year were less likely to die.
The new study is published as part of a special issue of The Lancet ahead of the American College of Cardiology’s 63rd Annual Scientific Session.
Notes to Editors