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ORIGINAL ARTICLE  AORTIC DISEASE Editor’s choice • Free accessfree

International Angiology 2019 June;38(3):219-24

DOI: 10.23736/S0392-9590.19.04152-X


language: English

Influence of earthquakes on the occurrence of aortic aneurysm ruptures

Gianmarco DE DONATO 1, Edoardo PASQUI 1, Emiliano CHISCI 2, Stefano MICHELAGNOLI 2, Luciano CARBONARI 3, Gabriele PAGLIARICCIO 3, Leonardo ERCOLINI 4, Giorgio VENTORUZZO 4, Marco VENTURA 5, Marco LEOPARDI 5, Giovanni CREDI 6, Massimo VIGANÒ 6, Antonio ANTICO 7, Luigi DI MATTEO 7, Massimo LENTI 8, Giacomo ISERNIA 8, Domenico ALBERTI 9, Francesco SETACCI 10, Domenico BENEVENTO 1, Giancarlo PALASCIANO 1, Carlo SETACCI 1

1 Division of Vascular Surgery, Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy; 2 Unit of Vascular Surgery, San Giovanni di Dio Hospital, Florence, Italy; 3 Unit of Vascular Surgery, Ospedali Riuniti di Ancona, Ancona, Italy; 4 Unit of Vascular Surgery, San Donato Hospital, Arezzo, Italy; 5 Unit of Vascular Surgery, San Salvatore Hospital, L’Aquila, Italy; 6 Unit of Vascular Surgery, Hospital of Massa Carrara, Massa Carrara, Italy; 7 Unit of Vascular Surgery, Santo Spirito Civil Hospital, Pescara, Italy; 8 Unit of Vascular Surgery, Santa Maria della Misericordia Hospital, Perugia, Italy; 9 Unit of Vascular Surgery, Santa Maria Civil Hospital, Terni, Italy; 10 Unit of Vascular Surgery, Multimedica Institute for Research and Care, Milan, Italy

BACKGROUND: Catastrophic events have been correlated to increased incidence of cardio-vascular events, but no correlation between RAA and seismic activities have ever been investigated.
METHODS: Hospital admissions related to RAA between January 2014 and December 2016 were retrospectively assessed in nine vascular centers of central Italy and correlated with date-matched seismic events. Correlation between RAA presentation and seismic event was first evaluated by Linear Regression analysis. Incidence of RAA events, mortality rate, and type of intervention were analyzed during seismic days (SD) and compared to outcomes during non-seismic days (nSD).
RESULTS: A total of 376 patients were admitted with a diagnosis of RAA, and a total of 783 seismic events were reviewed. Twenty patients died before intervention (untreated). Open surgery was performed in 72.8%, endovascular treatment in 27.2%. General mortality at 30 days was 26.6% (30.5% for open surgery; 21.6% for endovascular treatment; P=0.24). Linear regression analysis between RAA and seismic periods revealed a significant correlation (slope=0.11±0.04, equation: y = 0.1143 x + 3.034, P=0.02). Incidence of RAA was 0.34 event per day during the entire period, 0.32 during nSD and 0.44 during SD (P=0.006). During seismic days, patients with RAA were older (80.5 years during SD vs. 77 years during nSD, P=0.12), were in poorer general condition at admission and remained untreated more frequently (8% SD vs. 4.7% nSD, P=0.3), and had a higher mortality rate at 30 days (46.2% SD vs. 27.2% nSD, P=0.012).
CONCLUSIONS: During seismic days, the incidence of RAA is higher in comparison to non-seismic days. Patients with rupture during seismic days have a higher risk of death.

KEY WORDS: Aortic aneurysm; Ruptured aneurysm; Earthquakes; Incidence

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