Ultrasound screening for abdominal aortic aneurysms

Engelberger, Stephan; Rosso, Raffaele; Sarti, Manuela; Grande, Filippo Del; Canevascini, Reto; Berg, J C van den; Prouse, Giorgio; Giovannacci, Luca

doi:10.4414/smw.2017.14412

Cited by 3 publications

(4 citation statements)

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“…We excluded 779 for following reasons: 82 records because they were case reports/case series, 11 were comments, 10 were editorials, 7 clinical guidelines, 79 were systematic reviews, 13 were meta-analyses that did not include cross-sectional studies on risk factors, 577 were about other topics. A total of 40 papers were considered for systematic review (Figure 1) [4,9,10,11,12,13,15,16,17,18,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62].…”

Section: Resultsmentioning

confidence: 99%

“…Some studies that include females show that AAA prevalence is always higher compared to males [4,11,17,18,34,35,39,42,44,47,50,51,54,55]. It is important to underline that association between males and AAA could be attributed to a greater predisposition of males than to females to cardiovascular disease, known as “male disadvantage” [75].…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Abdominal Aortic Aneurysm in Population-Based Studies: A Systematic Review and Meta-Analysis

Altobelli

Rapacchietta

Profeta

et al. 2018

IJERPH

142

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Abdominal aortic aneurysm (AAA) represents an important public health problem with a prevalence between 1.3% and 12.5%. Several population-based randomized trials have evaluated ultrasound screening for AAA providing evidence of a reduction in aneurysm-related mortality in the screened population. The aim of our study was to perform a systematic review and meta-analysis of the risk factors for AAA. We conducted a systematic review of observational studies and we performed a meta-analysis that evaluated the following risk factors: gender, smoking habits, hypertension, coronary artery disease and family history of AAA. Respect to a previous a meta-analysis we added the funnel plot to examine the effect sizes estimated from individual studies as measure of their precision; sensitivity analysis to check the stability of study findings and estimate how the overall effect size would be modified by removal of one study; cumulative analysis to evaluate the trend between studies in relation to publication year. Abdominal aortic aneurysm prevalence is higher in smokers and in males. On the other hand, while diabetes is a risk factor for many cardiovascular diseases, it is not a risk factor for AAA. In addition, it is important to underline that all countries, where AAA screening was set up, had high income level and the majority belong to Western Europe (United Kingdom, Sweden, Italy, Poland, Spain and Belgium). Abdominal aortic aneurysm screening is fundamental for public health. It could avoid deaths, ruptures, and emergency surgical interventions if abdominal aortic aneurysm was diagnosed early in the population target for screening.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk Factors for Abdominal Aortic Aneurysm in Population-Based Studies: A Systematic Review and Meta-Analysis

Altobelli

Rapacchietta

Profeta

et al. 2018

IJERPH

142

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“…Reducing Mortality. The screening detected point prevalence of AAAs in men varied from 1.5% to 7.1% (Chun et al, 2013;Engelberger et al, 2017;McCaul et al, 2016;Svensjö et al, 2013;Wanhainen et al, 2016). Among these screen-detected AAAs, 0.4%-7% were large aneurysms (greater than 5.5 cm) (Chun et al, 2013;McCaul et al, 2016;Wanhainen et al, 2016).…”

Section: Benefits Of Male Aaa Screeningmentioning

confidence: 99%

“…The number of inappropriate AAA screenings has continued to decrease, demonstrating greater awareness and application of the AAA screening guidelines by primary care providers. Engelberger et al, 2017, Switzerland To assess the feasibility, acceptance, and costs of an ultrasound scan screening program for AAA in the elderly male population A prospective cohort study of male patients aged 65-80 years, who attended the outpatient clinics of the Lugano Regional Hospital in 2013, were invited for an ultrasound examination of their abdominal aorta (n = 1634). Screening men aged 65-80 for AAA is feasible, requiring limited financial and organizational effort.…”

Section: Benefits Of Male Aaa Screeningmentioning

confidence: 99%

Screening Older Adult Men for Abdominal Aortic Aneurysm: A Scoping Review

et al. 2021

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Abdominal aortic aneurysm (AAA) is a potentially fatal condition predominantly affecting older adult men (60 years or over). Based on evidence, preventative health-care guidelines recommend screening older males for AAA using ultrasound. In attempts to reduce AAA mortality among men, screening has been utilized for early detection in some Western countries including the UK and Sweden. The current scoping review includes 19 empirical studies focusing on AAA screening in men. The findings from these studies highlight benefits and potential harms of male AAA screening. The benefits of AAA screening for men include decreased incidence of AAA rupture, decreased AAA mortality, increased effectiveness of elective AAA repair surgery, and cost-effectiveness. The potential harms of AAA screening included lack of AAA mortality reduction, negative impacts on quality of life, and inconsistent screening eligibility criteria being applied by primary care practitioners. The current scoping review findings are discussed to suggest changes to AAA screening guidelines and improve policy and practice.

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Hospital incidence and mortality of patients treated for abdominal aortic aneurysms in Switzerland – a secondary analysis of Swiss DRG statistics data

Meuli¹,

Menges²,

Steigmiller³

et al. 2022

Swiss Med Wkly

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AIM OF THE STUDY: To analyse hospital incidence and in-hospital mortality of patients treated for abdominal aortic aneurysms in Switzerland. METHODS: Secondary data analysis of case-related hospital discharge data of the Swiss Federal Statistical Office for the years 2009–2018. Patients who were hospitalised and surgically treated for nonruptured abdominal aortic aneurysms or hospitalised and treated for ruptured abdominal aortic aneurysms were included in the analysis. Standardised annual incidences rates were calculated using the European standard population 2013. In-hospital all-cause mortality rates were calculated as raw values and standardised for age, sex, and the van Walraven comorbidity score. RESULTS: A total of 10,728 cases were included in this study, of which 87.1% were male. Overall, 22.7% of the patients presented with a ruptured abdominal aortic aneurysm; 46% of these cases were surgically treated whereas 54% received conservative therapy. The age-standardised cumulative hospital incidences for treatment of nonruptured abdominal aortic aneurysms were 2.6 (95% confidence interval 2.5–2.8) and 19.7 (19.2–20.1) per 100,000 for women and men, respectively; for ruptured aneurysms it was 0.4 (0.3–2.4) per 100,000 in women, and 2.7 (2.6–2.9) in men. The annual incidence rates were stable in the decade observed. The adjusted mortality rates for treatment of nonruptured aneurysms decreased from 5.5% (2.6–11.2%) in 2009 to 1.4% (0.5–3.6%) in 2018 in women, and from 2.4% (1.3–4.5%) in 2009 to 0.6% (0.2–1.5%) in 2018 in men. The adjusted mortality rates for treatment of ruptured abdominal aortic aneurysms remained high without relevant improvements for either sex over time: for women 32.4% (24.1–42.1%), for men 19.7% (16.8–22.8%). CONCLUSIONS: The hospital incidence rates for nonruptured and ruptured abdominal aortic aneurysms remained unchanged in the decade observed. Compared with Germany, there was no evidence for a decrease in the annual incidence rates for ruptured abdominal aortic aneurysms in Switzerland. Mortality rates in the elective setting were low and decreased in the last decade but remained high in patients treated for ruptured aneurysms. Efforts to reduce the incidence of ruptured abdominal aortic aneurysms are needed to reduce aneurysm-related mortality in Switzerland.

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Ultrasound screening for abdominal aortic aneurysms

Abstract: AAA screening of male patients aged 65-80 years is feasible with limited financial and organisational effort. Adherence might be improved by a larger community-based programme and involvement of general practitioners.

Cited by 3 publications

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Risk Factors for Abdominal Aortic Aneurysm in Population-Based Studies: A Systematic Review and Meta-Analysis

Risk Factors for Abdominal Aortic Aneurysm in Population-Based Studies: A Systematic Review and Meta-Analysis

Screening Older Adult Men for Abdominal Aortic Aneurysm: A Scoping Review

Hospital incidence and mortality of patients treated for abdominal aortic aneurysms in Switzerland – a secondary analysis of Swiss DRG statistics data

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