**Author details**

statistics, ANOVA, chi-square, logistic multiple regression, McNemar's and gamma tests were used for dealing with different objectives of the study. AAA and TA were most frequent aneurysm types. DSA and US were the most frequent imaging methods. OAR was much more frequently used than EVAR. Age group, male, and comorbidities had distinct effects on aneurysm frequency. More patients went to urban teaching and urban non-teaching, large-volume hospitals for emergency and elective admissions and were supported by medical reimbursement schemes. However, none of these patient characteristics or hospital contexts had any effect on frequency-based ranking of imaging methods or intervention procedures. Results supported the view that imaging methods have a distinct effect on mortality. DSA recorded lowest and CT recorded highest mortality. Out of the intervention procedures, EVAR had lower mortality than OAR. However, in combination, OAR with DSA as the imaging method recorded lowest mortality. There was a distinct effect of hospital stay on these mortalities due to imaging methods with longer than 10 days for any imaging method increasing mortality risk. Definite effect of ACR compliance was observed. With increasing compliance, mortality rate reduced and became zero with full compliance. Thus, improving ACR compliance and patients selecting only compliant hospitals will reduce aneurysm mortality significantly. Results of logistic multiple regression were used for the development of probability equations for mortality with imaging methods alone and in combination with intervention procedures. From a detailed analysis of patient characteristics and hospital contexts, age group and comorbidities emerged as the most important predictors of mortality probability. Other factors were less important as

Overall, imaging methods affect mortality, and increasing compliance with ACR appropriateness criteria reduces mortality considerably. Probability of in-hospital mortality can be predicted using models with imaging methods with or without

intervention procedures and adding age and comorbidity as predictors.

they provided inconsistent results.

*Aortic Aneurysm and Aortic Dissection*

None declare conflict of interest.

TA thoracic aortic aneurysm

AAA abdominal aortic aneurysm

EVAR endovascular aortic repair

CT computed tomography imaging CTA computed tomography angiography

MRI magnetic resonance imaging MRA magnetic resonance angiography

OAR open aortic repair

US ultrasound imaging

rTA ruptured thoracic aortic aneurysm TAA thoracicoabdominal aortic aneurysm

rAAA ruptured abdominal aortic aneurysm

DSA digital subtraction angiography imaging

rTAA ruptured thoracicoabdominal aortic aneurysm

**Conflict of interest**

**List of abbreviations**

**40**

Abdullah Al Amoudi<sup>1</sup> , Shankar Srinivasan<sup>2</sup> and Mohamed Yacin Sikkandar<sup>1</sup> \*

1 College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia

2 Biomedical Informatics Program in Rutgers-SHP's Health Informatics Department, NJ, USA

\*Address all correspondence to: m.sikkandar@mu.edu.sa

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
