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CC BY 4.0 · Aorta (Stamford) 2019; 07(04): 108-114
DOI: 10.1055/s-0039-1692456
Original Research Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Comorbidities Associated with Large Abdominal Aortic Aneurysms

Verena Müller  ‡   #
1   Surgical Clinic, Campus Charité Mitte and Campus Virchow-Klinikum, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
,
Milena Miszczuk‡   #
2   Vascular Surgery Clinic, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
,
Christian E. Althoff
3   Institute of Radiology, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
,
Andrea Stroux 
4   Institute of Medical Biometrics and Clinical Epidemiology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
,
Andreas Greiner
2   Vascular Surgery Clinic, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
,
Helena Kuivaniemi 
5   Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
,
Irene Hinterseher 
2   Vascular Surgery Clinic, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
› Author Affiliations Funding None.
Further Information

Publication History

24 April 2018

24 April 2019

Publication Date:
05 December 2019 (online)

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Abstract

Background Abdominal aortic aneurysm has become increasingly important owing to demographic changes. Some other diseases, for example, cholecystolithiasis, chronic obstructive pulmonary disease, and hernias, seem to co-occur with abdominal aortic aneurysm. The aim of this retrospective analysis was to identify new comorbidities associated with abdominal aortic aneurysm.

Methods We compared 100 patients with abdominal aortic aneurysms and 100 control patients. Their preoperative computed tomographic scans were examined by two investigators independently, for the presence of hernias, diverticulosis, and cholecystolithiasis. Medical records were also reviewed. Statistical analysis was performed using univariate analysis and multiple logistic regression analysis.

Results The aneurysm group had a higher frequency of diverticulosis (p = 0.008). There was no significant difference in the occurrence of hernia (p = 0.073) or cholecystolithiasis (p = 1.00). Aneurysm patients had a significantly higher American Society of Anesthesiology score (2.84 vs. 2.63; p = 0.015) and were more likely to have coronary artery disease (p < 0.001), congestive heart failure (p < 0.001), or chronic obstructive pulmonary disease (p < 0.001). Aneurysm patients were more likely to be former (p = 0.034) or current (p = 0.006) smokers and had a significantly higher number of pack years (p < 0.001). Aneurysm patients also had a significantly poorer lung function. In multivariate analysis, the following factors were associated with aneurysms: chronic obstructive pulmonary disease (odds ratio, OR = 12.24; p = 0.002), current smoking (OR = 4.14; p = 0.002), and coronary artery disease (OR = 2.60; p = 0.020).

Conclusions Our comprehensive analysis identified several comorbidities associated with abdominal aortic aneurysms. These results could help to recognize aneurysms earlier by targeting individuals with these comorbidities for screening.

Keywords

abdominal aortic aneurysm - comorbidities - risk factor - lung function - smoking - diverticulosis

# These authors contributed equally to this work.


Supplementary Material

 

  • References

  • 1 Moll FL, Powell JT, Fraedrich G. , et al; European Society for Vascular Surgery. Management of abdominal aortic aneurysms clinical practice guidelines of the European Society for Vascular Surgery. Eur J Vasc Endovasc Surg 2011; 41 (Suppl. 01) S1-S58
    CrossrefPubMedGoogle Scholar
  • 2 Lederle FA. Screening for AAA in the USA. Scand J Surg 2008; 97 (02) 139-141
    CrossrefPubMedGoogle Scholar
  • 3 Medizin S. Bauchaorten-Screening bald im Check-up. MMW Fortschr Med 2016; 158: 33 . Doi: 10.1007/s15006-016-8991-5
    PubMedGoogle Scholar
  • 4 Nordon IM, Hinchliffe RJ, Loftus IM, Thompson MM. Pathophysiology and epidemiology of abdominal aortic aneurysms. Nat Rev Cardiol 2011; 8 (02) 92-102
    CrossrefPubMedGoogle Scholar
  • 5 Meijer CA, Kokje VB, van Tongeren RB. , et al. An association between chronic obstructive pulmonary disease and abdominal aortic aneurysm beyond smoking: results from a case-control study. Eur J Vasc Endovasc Surg 2012; 44 (02) 153-157
    CrossrefPubMedGoogle Scholar
  • 6 Schuster JJ, Raptopoulos V, Baker SP. Increased prevalence of cholelithiasis in patients with abdominal aortic aneurysm: sonographic evaluation. AJR Am J Roentgenol 1989; 152 (03) 509-511
    CrossrefPubMedGoogle Scholar
  • 7 Ito T, Kawaharada N, Kurimoto Y. , et al. Renal cysts as strongest association with abdominal aortic aneurysm in elderly. Ann Vasc Dis 2010; 3 (02) 111-116
    CrossrefPubMedGoogle Scholar
  • 8 Antoniou GA, Georgiadis GS, Antoniou SA, Granderath FA, Giannoukas AD, Lazarides MK. Abdominal aortic aneurysm and abdominal wall hernia as manifestations of a connective tissue disorder. J Vasc Surg 2011; 54 (04) 1175-1181
    CrossrefPubMedGoogle Scholar
  • 9 Antoniou GA, Giannoukas AD, Georgiadis GS. , et al. Increased prevalence of abdominal aortic aneurysm in patients undergoing inguinal hernia repair compared with patients without hernia receiving aneurysm screening. J Vasc Surg 2011; 53 (05) 1184-1188
    CrossrefPubMedGoogle Scholar
  • 10 Chun KC, Teng KY, Chavez LA. , et al. Risk factors associated with the diagnosis of abdominal aortic aneurysm in patients screened at a regional veterans affairs health care system. Ann Vasc Surg 2014; 28 (01) 87-92
    CrossrefPubMedGoogle Scholar
  • 11 Johnston KW, Rutherford RB, Tilson MD, Shah DM, Hollier L, Stanley JC. Suggested standards for reporting on arterial aneurysms. Subcommittee on Reporting Standards for Arterial Aneurysms, Ad Hoc Committee on Reporting Standards, Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery. J Vasc Surg 1991; 13 (03) 452-458
    CrossrefPubMedGoogle Scholar
  • 12 Fowkes FG, Anandan CL, Lee AJ. , et al. Reduced lung function in patients with abdominal aortic aneurysm is associated with activation of inflammation and hemostasis, not smoking or cardiovascular disease. J Vasc Surg 2006; 43 (03) 474-480
    CrossrefPubMedGoogle Scholar
  • 13 Cronenwett JL, Murphy TF, Zelenock GB. , et al. Actuarial analysis of variables associated with rupture of small abdominal aortic aneurysms. Surgery 1985; 98 (03) 472-483
    PubMedGoogle Scholar
  • 14 Spanos K, Rountas C, Saleptsis V, Athanasoulas A, Fezoulidis I, Giannoukas AD. The association of simple renal cysts with abdominal aortic aneurysms and their impact on renal function after endovascular aneurysm repair. Vascular 2016; 24 (02) 150-156
    CrossrefPubMedGoogle Scholar
  • 15 Cowan Jr JA, Dimick JB, Henke PK, Rectenwald J, Stanley JC, Upchurch Jr GR. Epidemiology of aortic aneurysm repair in the United States from 1993 to 2003. Ann N Y Acad Sci 2006; 1085: 1-10
    CrossrefPubMedGoogle Scholar
  • 16 Barisione C, Garibaldi S, Brunelli C. , et al. Prevalent cardiac, renal and cardiorenal damage in patients with advanced abdominal aortic aneurysms. Intern Emerg Med 2016; 11 (02) 205-212
    CrossrefPubMedGoogle Scholar
  • 17 Norman PE, Curci JA. Understanding the effects of tobacco smoke on the pathogenesis of aortic aneurysm. Arterioscler Thromb Vasc Biol 2013; 33 (07) 1473-1477
    CrossrefPubMedGoogle Scholar
  • 18 Henriksen NA, Sorensen LT, Jorgensen LN, Lindholt JS. Lack of association between inguinal hernia and abdominal aortic aneurysm in a population-based male cohort. Br J Surg 2013; 100 (11) 1478-1482
    CrossrefPubMedGoogle Scholar
  • 19 Alnassar S, Bawahab M, Abdoh A, Guzman R, Al Tuwaijiri T, Louridas G. Incisional hernia postrepair of abdominal aortic occlusive and aneurysmal disease: five-year incidence. Vascular 2012; 20 (05) 273-277
    CrossrefPubMedGoogle Scholar
  • 20 Ouriel K, Ricotta JJ, Adams JT, Deweese JA. Management of cholelithiasis in patients with abdominal aortic aneurysm. Ann Surg 1983; 198 (06) 717-719
    CrossrefPubMedGoogle Scholar
  • 21 Thomas JH. Abdominal aortic aneurysmorrhaphy combined with biliary or gastrointestinal surgery. Surg Clin North Am 1989; 69 (04) 807-815
    CrossrefPubMedGoogle Scholar
  • 22 Bogardus Jr ST. What do we know about diverticular disease? A brief overview. J Clin Gastroenterol 2006; 40 (Suppl. 03) S108-S111
    CrossrefPubMedGoogle Scholar
  • 23 Hauer-Jensen M, Bursac Z, Read RC. Is herniosis the single etiology of Saint's triad?. Hernia 2009; 13 (01) 29-34
    CrossrefPubMedGoogle Scholar
  • 24 Pitoulias GA, Donas KP, Chatzimavroudis G, Torsello G, Papadimitriou DK. The role of simple renal cysts, abdominal wall hernia, and chronic obstructive pulmonary disease as predictive factors for aortoiliac aneurysmatic disease. World J Surg 2012; 36 (08) 1953-1957
    CrossrefPubMedGoogle Scholar