RETROSPECTIVE CROSS-SECTIONAL STUDY OF AORTIC ANEURYSM AFTER INTRODUCING ELECTRONIC HEALTH SYSTEM AT KING HUSSEIN MEDICAL HOSPITAL

Objective To evaluate the clinical presentation and current management of aortic aneurysm patients in a tertiary care hospital in Amman, Jordan. Method All patients diagnosed with aortic aneurysm at the King Hussein Medical Hospital using the electronic health records (EHR) database Hakeem were evaluated between May 2016 and May 2018. Patients were then categorized according to the time duration between their diagnosis date and definitive treatment into 3 categories: Emergent (treatment on the same day of presentation), urgent (within one week) or elective (scheduled appointment). Definitive treatment was defined as either endovascular repair or open surgical repair. Results There were 49 cases of aortic aneurysm cases found in the Hakeem EHR database during that 2-year time interval, of them 92% were male, 94% were above 50 years old, and 61% were smokers. Thoracic cases were 14%, thoraco-abdominal cases were 8% and abdominal cases were 78%. The mean abdominal aneurysm size at presentation was 6.8 cm. Patients that were discovered incidentally with the aneurysm, were 43%. Elective, urgent and emergent groups were not significantly different in frequency. 63% of treated patients had endovascular repair. Nine patients refused to accept the risk of endovascular or surgical treatment. CT angiogram was used in 55% as the first investigation. The mean stay in hospital was 10.7 days, with 2.3 days in ICU and 6.1 days post-operatively. Conclusion Our results show the increased risk of aortic aneurysm in male patients above the age of 50 year, especially with a positive smoking history. One third of the patients required same day surgery to avoid immediate mortality. This outlines the late presentation of these cases due to the absence of screening. Hence, we recommend a one lifetime screening abdominal ultrasound for male smokers. Considering the high rate of smoking and other prevalent risk factors for developing aortic aneurysms, more studies are needed to evaluate the ideal age of starting this screening in Jordan. Implementing the electronic health system Hakeem has increased the accessibility and accuracy of research data and has lead to the increased awareness of this important issue