Pattern of aortic aneurysms in an African country

Abstract

OBJECTIVE: We sought to describe the regional, age, and sex distribution; diagnosis; treatment; and outcome of aortic aneurysms in a Kenyan population. METHODS: This was a retrospective study at Kenyatta National Hospital, Kenya. Records of black African patients whose final diagnosis was aortic aneurysm over the period from January 1998 to December 2007 were examined. Frequencies and means are presented in tables and bar charts. RESULTS: Two hundred sixty-four (92 male and 172 female patients) files were analyzed. The mean age was 56.15 years. Two hundred twenty-three (84.5%) aneurysms occurred in the abdominal aorta, followed by the descending aorta (7.5%), ascending aorta, (3.8%) and arch (1.9%). In 2.3% of cases, both the abdominal and thoracic aortas were affected. The male/female ratio was 1:1.9. Pain with swelling or a pulsatile mass was the predominant feature. More than 50% of the cases were diagnosed by means of ultrasonographic analysis. Sixty-one (23.1%) aneurysms were ruptured, and of this group, 44 (72.1%) patients died. Successful open surgical repair was done in 157 (59.5%) patients. Hypertension was a comorbidity in 137 (51.9%) cases. CONCLUSIONS: Aortic aneurysms in Kenya show abdominal segment and female predominance, occur 10 to 15 years earlier than in white populations, and carry high mortality from rupture. Hypertension was the leading associated risk factor. Ultrasonographic screening and control of blood pressure might be useful preventive measures