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Uninsured face higher death risk from aorta problems

ANN ARBOR, MI Add another item to the list of health threats that people without health insurance face and this one is especially deadly. A new study from the University of Michigan Cardiovascular Center finds that a patient's insurance status makes a huge difference in how well they fare if they have a potentially lethal aortic aneurysm.

Not only are uninsured people with the condition more likely to be diagnosed only after their aorta bursts, but they're also twice as likely as insured patients to die after surgery to fix the problem even if the operation is done before the aneurysm ruptures.

The findings, published in the current issue of the journal Surgery, represent the first confirmation of a long-suspected effect: that there's a deadly downside to the delay in detection and treatment of abdominal aortic aneurysms that results from uninsured patients' lack of access to regular medical care.

"Although we can't be completely sure that all these patients' aneurysms would have been detected before rupturing if they had insurance, the sizable differences in stage of diagnosis and outcomes between the insured and uninsured strongly suggest that access to care plays a significant role in detecting aneurysms before they rupture," says senior author Gilbert R. Upchurch Jr., M.D., an assistant professor of vascular surgery at the U-M Medical School. "In other words, access is linked directly to death."

Upchurch led the study with former U-M medical student Leslie K. Boxer, M.D., now at Cornell University, using data from the National Inpatient Sample database compiled by the federal Agency for Healthcare Research and Quality.

Doctors call abdominal aortic aneurysms "triple A's", an innocuous-sounding name for a truly deadly condition that kills nearly 16,000 people each year. Starting as a tiny bulge in the wall of the body's largest blood vessel an AAA can stay intact or grow slowly for years, often without symptoms, befor
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
23-Sep-2003


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