Analysis of High-Risk Factors Associated with the Progression of Subaneurysmal Aorta to Abdominal Aortic Aneurysm in Rural Area in China

Abstract

Objective: To determine the risk factors associated with the progress of subaneurysmal aorta (SAA) to abdominal aortic aneurysm (AAA) and provide a reference for the prevention of AAA in rural areas. Methods: A total of 747 SAA patients screened by the Health Management Center of the Second Hospital of Lanzhou University from January 2015 to January 2016 were recruited. The ratio of SAA progressing to AAA was observed through 5 years of follow-up. Logistic stepwise regression analysis was performed to analyze the high-risk factors. The relevant clinical prediction model score table (Nom) was made and the C-index and calibration chart were used to verify the prediction ability of the model. Results: Of the 747 patients diagnosed with SAA, 260 developed to AAA, with an incidence of 34.8%. Univariate analysis showed that age (62-65 years old), abdominal aorta diameter greater than 2.7 cm, smoking after 30 years old, moderate to severe hypertension, and blood pressure variability were the important high-risk factors of SAA progressing to AAA. Logistic regression analysis showed that these factors were statistically significant. The nomogram of clinical prediction model score showed that when 50-60% of SAA developed to AAA, the score was 189-201 and the C-index was 0.883, verifying the moderate predictive ability of this model. Conclusion: Age, smoking habit, degree of hypertension, and control situation were highrisk factors associated with the progression of SAA to AAA. The control of the above highrisk factors was imperative for the prevention of AAA in rural areas without sufficient medical resources.

The burden of aortic aneurysm in China from 1990 to 2019: findings from the Global Burden of Disease Study 2019

“…The reported risk factors for AA included male sex [ 27 , 28 ], white race [ 28 ], smoking [ 27 , 28 ], hypertension [ 27 ], high low-density lipoprotein [ 28 ], and hypercholesteremia [ 28 – 30 ]. For the Chinese population, it was reported that age, smoking habits, degree of hypertension, and poor control of hypertension were high-risk factors for the formation and progression of AAA [ 31 ]. In our present study, the most predominant attributable risk factors for AA burden were high systolic blood pressure and smoking; in addition, the AA-induced death rate attributed to these two risk factors was higher in males.…”