Screening for Abdominal Aortic Aneurysms and Risk Factors in 65-Year-Old Men in Oslo, Norway

Abstract

Purpose To investigate the prevalence of and risk factors for abdominal aortic aneurysm (AAA) in 65-year-old men in Oslo, Norway. Materials and Methods From May 2011, until September 2019, the annual population of 65-year-old men living in Oslo were invited to an ultrasonographic screening of the abdominal aorta. Candidates received a one-time invitation by mail, including a questionnaire on possible risk factors and comorbidities. Abdominal aortic outer-to-outer diameter and ankle-brachial index were measured by the screening team. Participants were allocated into three groups: non-, sub- and aneurysmal aorta. Written information on recommended follow-up regime was given to participants with an aortic diameter ≥25 mm. Univariate and multivariate analyses of potential risk factors were performed, in addition to descriptive analyses and significance testing. Results In total, 19,328 were invited, 13,215 men were screened, of which 12,822 accepted inclusion in the study. Aortic diameter was registered for 12,810 participants and 330 men had aortic diameter ≥30 mm, giving a prevalence of AAA of 2.6% (95% confidence interval (CI) 2.31–2.86). We identified 4 independent risk factors for AAA: smoking (OR = 3.64, 95% CI 2.90–4.58), hypertension (OR = 1.87, 95% CI 1.49–2.35), BMI >30 (OR = 1.02, 95% CI 1.00–1.03), and diabetes mellitus (OR = 0.52, 95% CI 0.35–0.79), the latter showing an inverse association with AAA growth. A subgroup of 862 men with aortic diameters 25–29 mm had a significantly higher prevalence of BMI >25, smoking and family history of AAA, compared to participants with aortic diameter <25 mm. Conclusion Among the participants in this study, the prevalence of abdominal aortic aneurysms was 2.6%. Participants with AAA more frequently reported cardiovascular risk factors, and less frequently diabetes mellitus.

Eleven-Year Outcomes of a Screening Project for Abdominal Aortic Aneurysm (AAA) in 65-Year-Old Men

“…During the screening period, from May 2011 to September 2019, a total of 13,215 men were screened. 21 In total, 330 men with AAA and 859 men with subaneurysmal aortic dilatation were detected and included in this study (Figure 1). In addition, 859 men with aortic diameter <25 mm upon screening were included, leaving a total number of 2048 participants for the final analysis.…”

“…The screening project is described in detail, by Rabben et al, in previously published work on AAA prevalence and risk factors in the same study population. 21 Annually, 65-year-old men living in Oslo are invited to AAA screening once by letter. The AAA screening is conducted at the Department of Vascular Surgery at Oslo University Hospital by specially trained nurses and radiographers.…”

“…AAA surveillance in By September 2019, 13,215 men had been screened, revealing an AAA prevalence of 2.6% in this population. 21 The attendance rate varied from 63% to 78%. Demographics for this screened population, such as smoking and comorbidities, have been reported in a previous study, in which four independent risk factors for AAA were identified -smoking, hypertension, BMI >30 and diabetes mellitus, of which the latter had an inverse relation.…”

“…Demographics for this screened population, such as smoking and comorbidities, have been reported in a previous study, in which four independent risk factors for AAA were identified -smoking, hypertension, BMI >30 and diabetes mellitus, of which the latter had an inverse relation. 21 All deaths during the study period were accounted for through the National Population Register. Causes of death were obtained from patient electronic medical records at Oslo University Hospital and the Norwegian Cause of Death Registry (CoDR).…”

“…20 Since 2011, the Department of Vascular Surgery at Oslo University Hospital has conducted a research project in which AAA screening is offered to 65-year-old men living in Oslo, Norway. 21 The aim of this study was to evaluate the effect of the screening project on AAA-related mortality, AAA rupture rate and AAA repair rate.…”