Abdominal aorta aneurysm screening program in Swietokrzyskie Voivodeship: early results
Abstract
Introduction: The prevalence of abdominal aorta aneurysms (AAA) is estimated to be between 1.3–12.5%
in men and 5.2% in women, which poses a serious public health issue. Ruptured aorta aneurysm most often
causes internal bleeding and ultimately leads to death. The cause of high mortality is the asymptomatic occurrence
of AAA. Usually, the first symptom is its rupture
The aim of our paper is to provide a relationship between the percentage of the population reporting to the
vascular surgeon and the type of residence based on the analysis of data from screening studies carried out in
one of the regions of Poland.
Material and methods: Patients previously informed about the free diagnostics in the Provincial Hospital in
Kielce were examined by qualified physicians with ESAOTE MyLab Seven ultrasound device. Prior to that, patients
were asked to fill a questionnaire to acquire data about their risk factors, demography, and medical history.
Results: A total of 22 (7.3%) aneurysms were found in a group of 301 patients, of which 20 (6.6%) were
found in men and 2 (0.66%) in women.
Conclusions: Screening tests are an effective method to significantly improve early detection of AAAs. However,
it is necessary to provide easier access to health professionals qualified to perform ultrasound examinations.
It is especially important for the population of men with a family history of AAA, because they are at a higher
risk of developing this pathology. The incidence rate of AAA observed in our study is consistent with the data
published in worldwide literature.
Keywords: abdominal aorta aneurysmsscreeningprevalence
References
- Golledge J, Muller J, Daugherty A, et al. Abdominal aortic aneurysm: pathogenesis and implications for management. Arterioscler Thromb Vasc Biol. 2006; 26(12): 2605–2613.
- Zuo SW, Kui YQ, Chen F, et al. A matched case-control study of risk factors in abdominal aortic aneurysm. Journal of Peking University (Health Sciences). 2014; 46(3): 412–416.
- Kent KC, Zwolak RM, Egorova NN, et al. Analysis of risk factors for abdominal aortic aneurysm in a cohort of more than 3 million individuals. J Vasc Surg. 2010; 52(3): 539–548.
- Linné A, Forsberg J, Leander K, et al. Screening of siblings to patients with abdominal aortic aneurysms in Sweden. Scand Cardiovasc J. 2017; 51(3): 167–171.
- Shiraev T, Condous MG. Incidence and outcomes of ruptured abdominal aortic aneurysms in rural and urban Australia. ANZ J Surg. 2013; 83(11): 838–843.
- Chabok M, Nicolaides A, Aslam M, et al. Risk factors associated with increased prevalence of abdominal aortic aneurysm in women. Br J Surg. 2016; 103(9): 1132–1138.
- Persson SE, Boman K, Wanhainen A, et al. Decreasing prevalence of abdominal aortic aneurysm and changes in cardiovascular risk factors. J Vasc Surg. 2017; 65(3): 651–658.
- Moll FL, Powell JT, Fraedrich G, et al. European Society for Vascular Surgery. Management of abdominal aortic aneurysms clinical practice guidelines of the European society for vascular surgery. Eur J Vasc Endovasc Surg. 2011; 41 Suppl 1: S1–S58.
- Crilly MA, Mundie A, Bachoo P, et al. Influence of rurality, deprivation and distance from clinic on uptake in men invited for abdominal aortic aneurysm screening. Br J Surg. 2015; 102(8): 916–923.
- Lesjak MS, Flecknoe-Brown SC, Sidford JR, et al. Evaluation of a mobile screening service for abdominal aortic aneurysm in Broken Hill, a remote regional centre in far western NSW. Aust J Rural Health. 2010; 18(2): 72–77.
- Fukuda S, Watanabe H, Iwakura K, et al. Multicenter Investigations of the Prevalence of Abdominal Aortic Aneurysm in Elderly Japanese Patients With Hypertension. Circulation Journal. 2015; 79(3): 524–529.
- Silverstein MD, Pitts SR, Chaikof EL, et al. Abdominal aortic aneurysm (AAA): cost-effectiveness of screening, surveillance of intermediate-sized AAA, and management of symptomatic AAA. Proc (Bayl Univ Med Cent). 2005; 18(4): 345–367.
- Takagi H, Ando T, Umemoto T, et al. ALICE (All-Literature Investigation of Cardiovascular Evidence) Group. Abdominal Aortic Aneurysm Screening Reduces All-Cause Mortality: Make Screening Great Again. Angiology. 2018; 69(3): 205–211.
- Krumholz HM, Keenan PS, Brush JE, et al. American Heart Association Interdisciplinary Council on Quality of Care and Outcomes Research, American College of Cardiology Foundation. Standards for measures used for public reporting of efficiency in health care: a scientific statement from the American Heart Association Interdisciplinary Council on Quality of Care and Outcomes research and the American College of Cardiology Foundation. J Am Coll Cardiol. 2008; 52(18): 1518–1526.
- Altobelli E, Rapacchietta L, Profeta VF, et al. Risk Factors for Abdominal Aortic Aneurysm in Population-Based Studies: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2018; 15(12).
- Aune D, Schlesinger S, Norat T, et al. Tobacco smoking and the risk of abdominal aortic aneurysm: a systematic review and meta-analysis of prospective studies. Sci Rep. 2018; 8(1): 14786.
- Ying AJ, Affan ET. Abdominal Aortic Aneurysm Screening: A Systematic Review and Meta-analysis of Efficacy and Cost. Ann Vasc Surg. 2019; 54: 298–303.e3.
- Durieux R, Van Damme H, Labropoulos N, et al. High prevalence of abdominal aortic aneurysm in patients with three-vessel coronary artery disease. Eur J Vasc Endovasc Surg. 2014; 47(3): 273–278.
- García SLB. Abdominal aortic aneurysm. Prevalence and associated risk factors in a population of patients hospitalised in Internal Medicine. Revista Clínica Española (English Edition). 2018; 218(9): 455–460.
- Itoga N, Rothenberg K, Suarez P, et al. VESS07. Metformin Prescription Status and Abdominal Aortic Aneurysm Disease Progression in the U.S. Veteran Patient Population. Journal of Vascular Surgery. 2018; 67(6): e52.
- Kniemeyer HW, Kessler T, Reber PU, et al. Treatment of ruptured abdominal aortic aneurysm, a permanent challenge or a waste of resources? Prediction of outcome using a multi-organ-dysfunction score. Eur J Vasc Endovasc Surg. 2000; 19(2): 190–196.
- Ashton HA, Gao L, Kim LG, et al. Fifteen-year follow-up of a randomized clinical trial of ultrasonographic screening for abdominal aortic aneurysms. Br J Surg. 2007; 94(6): 696–701.
- Lindholt JS, Sørensen J, Søgaard R, et al. Long-term benefit and cost-effectiveness analysis of screening for abdominal aortic aneurysms from a randomized controlled trial. Br J Surg. 2010; 97(6): 826–834.
- Norman P, Jamrozik K, Lawrence-Brown M, et al. Population based randomised controlled trial on impact of screening on mortality from abdominal aortic aneurysm. BMJ. 2004; 329(7477): 1259.
- Palombo D, Lucertini G, Pane B, et al. Screening for abdominal aortic aneurysm. Questions and results. Acta Chir Belg. 2011; 111(1): 7–11.
- Stanišić MG, Rzepa T, Gawrońska A, et al. Personal resources and satisfaction with life in Marfan syndrome patients with aortic pathology and in abdominal aortic aneurysm patients. Kardiochir Torakochirurgia Pol. 2018; 15(1): 27–30.
- Overbey DM, Glebova NO, Chapman BC, et al. Morbidity of endovascular abdominal aortic aneurysm repair is directly related to diameter. J Vasc Surg. 2017; 66(4): 1037–1047.e7.
- Png CY, Tadros RO, Faries PL, et al. The Effect of Age on Post-EVAR Outcomes. Ann Vasc Surg. 2016; 35: 156–162.
- Hye RJ, Janarious AU, Chan PH, et al. Survival and Reintervention Risk by Patient Age and Preoperative Abdominal Aortic Aneurysm Diameter after Endovascular Aneurysm Repair. Ann Vasc Surg. 2019; 54: 215–225.