Aged; Aortic Aneurysm, Abdominal/economics/epidemiology/ultrasonography; Belgium/epidemiology; Costs and Cost Analysis; Humans; Incidence; Male; Mass Screening/economics; Risk Factors
Abstract :
[en] Unruptured abdominal aortic aneurysm (AAA) is seldom recognized. Thus it is difficult to know whether the incidence of AAA in the general population is high enough to warrant routine screening at least in men after a certain age. Ultrasound screening studies to evaluate the incidence of AAA have been carried out in several English-speaking and Scandinavian countries. The purpose of this report is to describe the results of a study carried out in Belgium. All 65- and 75-year-old men living in the city of Liege, Belgium, were given the opportunity to undergo a free ultrasound examination. Only 41% of the target population was examined. AAA defined as abdominal aortic diameter of >30 mm was observed in 28 subjects (incidence: 3.8%). Mean abdominal aortic diameter was 34.7 mm. A diameter >29 mm was observed in 33 subjects (incidence 4.5%). Mean abdominal aortic diameter was 30.4 mm. On the basis of epidemiological data collected, a high-risk population for AAA was identified. Arterial hypertension (p < 0.05), previous coronary artery surgery (p < 0.05), and smoking (p < 0.06) were more common in subjects with than without AAA. The overall cost of screening was $18.175. The cost per AAA diagnosed was $551.00.
Disciplines :
Surgery
Author, co-author :
Vazquez, C.
SakalihasanN, Natzi ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie cardio-vasculaire
D'Harcour, J. B.
Limet, Raymond ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie cardio-vasculaire
Language :
English
Title :
Routine ultrasound screening for abdominal aortic aneurysm among 65- and 75-year-old men in a city of 200,000 inhabitants.
Publication date :
1998
Journal title :
Annals of Vascular Surgery
ISSN :
0890-5096
eISSN :
1615-5947
Publisher :
Springer Verlag, New York, United States - New York
Ernst, C.B., Abdominal aortic aneurysm (1993) N Engl J Med, 328, pp. 1167-1172
Quill, D.S., Colgard, M.P., Sumner, D.S., Ultrasound screening for the detection of abdominal aortic aneurysms (1984) Surg Clin North Am, 69, pp. 713-714
Collin, J., Screening for abdominal aortic aneurysms (1985) Br J Surg, 72, pp. 831-852
Reitsma, J.B., Pleumeekers, H.J.C.M., Hoes, A.W., Increasing incidence of aneurysms of the abdominal aorta in the Netherlands (1996) Eur J Vasc Endovasc Surg, 12, pp. 446-451
Hak, E., Balm, R., Rikelboom, B.C., Abdominal aortic aneurysm screening: An epidemiological point of view (1996) Eur J Vasc Endovasc Surg, 11, pp. 270-278
Limet, R., Sakalihasan, N., Albert, A., Determination of the expansion rate and incidence of rupture of abdominal aortic aneurysms (1991) J Vasc Surg, 14, pp. 540-548
Ingoldby, C.J.H., Impact of vascular surgery on community mortality from ruptured abdominal aortic aneurysms (1986) Br J Surg, 73, pp. 551-553
Crawford, E.S., Saleh, S.A., Bahh, J.W., Infrarenal abdominal aortic aneurysm: Factors influencing survival after operation performed over a 25-year period (1981) Ann Vasc Surg, 193, pp. 699-709
Bengtsson, H., Sonesson, N.B., Bergqvist, D., Incidence and prevalence of abdominal aortic aneurysms, estimated by necropsy studies and population screening by ultrasound (1996) Ann NY Acad Si, 800, pp. 1-24
Castleden, W.H., Mercer, J.C., Abdominal aortic aneurysms in Western Australia: Descriptive epidemiology and patterns of rupture (1980) Br J Surg, 72, pp. 109-112
Mellon, L.J., Bickerstaff, L.K., Hollier, L.H., Changing incidence of abdominal aortic aneurysms: A population-based study (1984) Am J Epidemiol, 120, pp. 379-386
Ellis, M., Powell, J.T., Place, J., The limitations of ultrasound in surveillance of small abdominal aortic aneurysms (1990) The Cause and Management of Aneurysms, pp. 117-121. , Greenhalgh RM, Mannick JA, eds. Philadelphia: W.B. Saunders
Smith, F.C.T., Grimshaw, G.M., Ultrasonographic screening for abdominal aortic aneurysm in an urban community (1993) Br J Surg, 80, pp. 1406-1409
Akkersdijk, G.J., Puylaert, J.B.C., De Vries, A.C., Abdominal aortic aneurysm as an incidental finding in abdominal ultrasonography (1991) Br J Surg, 78, pp. 1261-1263
Gordenne, W., Parmentier, J.C., Résultats d'Une Expérience de ́Pistage par Unité Mobile en Province de Liège, , Personal communication
Grimshaw, G.M., Docker, M.F., Accurate screening for abdominal aortic aneurysm (1992) Chim Phys Physiol Med, 13 (2), pp. 135-138
Comslock, C.E., Bluth, R., Interobserver variability in ultrasonic evaluation of abdominal aortic aneurysms (1994) LA State Med Soc, 146, pp. 526-530
McGregor, J.C., Pollock, J.G., Anton, H.C., The value of ultrasonography in the diagnosis of abdominal aortic aneurysms (1975) Scott Med J, 20, pp. 133-137
Johnston, K.W., Rutherford, R.B., Tilson, M.D., Shah, D.M., Hollier, L., Stanley, J.C., Suggested standards for reporting on arterial aneurysms (1991) J Vasc Surg, 13, pp. 452-458
Collin, J., Dépistage échographique des anévrysmes de l'aorte abdominale (1990) Les Anévrysmes de l'Aorte Abdominale, pp. 87-94. , Kieffer, E. ed. Paris: AERCV
Sonesson, B., Länne, T., Hansen, F., Sandgren, T., Infrarenal aortic diameter in the healthy person (1994) Eur J Vasc Surg, 8, pp. 89-95
Allen, P.I.M., Tudway, D., Goldman, M., Population screening for aortic aneurysm (1987) Br J Surg, 74, p. 332
Lederle, F.A., Walker, J.M., Reinke, D.B., Selective screening for abdominal aortic aneurysms with physical examination and ultrasound (1988) Arch Int Med, 148, pp. 1753-1756
Sakalihasan, N., Limet, R., Histoire naturelle des anévrysmes de l'aorte abdominale (1994) Rev Med Lg, 49, pp. 545-552
Sakalihasan, N., (1994) Contribution à la Détermination de l'Épidémiologie et de l'Histoire Naturelle des Anévrysrnes de l'Aorte Abdominale, , Doctoral thesis, University of Liege, October
Nevelsteen, A., Kim, Y., Meersman, A., Suy, R., Routine screening for unsuspected aortic aneurysms in patients after myocardial revascularisation: A prospective study (1991) Acta Cardiol, 46, pp. 201-206
Shapira, O.Z.M., Pasik, S., Wasserman, J.P., Barzilai, N., Mashiah, A., Ultrasound screening for abdominal aortic aneurysms in patients with atherosclerotic peripheral vascular disease (1990) J Cardiovasc Surg, 31, pp. 170-172
Allardice, J.T., Allwright, G.J., Wafula, J.M.C., Eyatt, A.P., High prevalence of abdominal aortic aneurysm in men with peripheral vascular disease: Screening by ultrasonography (1988) Br J Surg, 75, pp. 240-242