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Original article

Vol. 147 No. 0910 (2017)

Ultrasound screening for abdominal aortic aneurysms: A feasibility study in selected male population attending the outpatient clinics of the Regional Hospital of Lugano, Switzerland

DOI
https://doi.org/10.4414/smw.2017.14412
Cite this as:
Swiss Med Wkly. 2017;147:w14412
Published
03.03.2017

Summary

QUESTION UNDER STUDY

This pilot study aimed to assess the feasibility, acceptance and costs of an ultrasound scan screening programme for abdominal aortic aneurysms (AAA) in the elderly male population resident in Canton Ticino, Switzerland.

METHODS

The target population were male patients aged 65–80 years who attended the outpatient clinics of the Lugano Regional Hospital in 2013. The patients showing interest were contacted by phone to verify their eligibility and fix the appointment for the ultrasound scan of the abdominal aorta. Patients with recent examinations suitable for AAA detection were excluded. Aneurysm was defined as an abdominal aorta with sagittal and/or axial diameter ≥30 mm. Patients’ characteristics and study results were presented as descriptive statistics. The chi-squared test was used to compare categorical variables with p <0.05 as a statistical significance threshold.

RESULTS

1634 patients received the screening information leaflet and 745 (45.6%) underwent the ultrasound scan. Among the 1091 eligible patients, the acceptance rate was 68.3%. A previously unknown AAA was diagnosed in 31 patients (4.2%, 95% confidence interval 2.8–5.9%). Age and area of residence had a statistically significant impact on patient’s acceptance rate (p <0.05). The mean cost per screened patient was CHF 88.

CONCLUSIONS

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.

References

  1. Kniemeyer HW, Kessler T, Reber PU, Ris HB, Hakki H, Widmer MK. 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):190–6. doi:.https://doi.org/10.1053/ejvs.1999.0980
  2. IMPROVE Trial Investigators. Endovascular strategy or open repair for ruptured abdominal aortic aneurysm: one-year outcomes from the IMPROVE randomized trial. Eur Heart J. 2015;36(31):2061–9. doi:.https://doi.org/10.1093/eurheartj/ehv125
  3. Lederle FA, Johnson GR, Wilson SE ; Aneurysm Detection and Management Veterans Affairs Cooperative Study. Abdominal aortic aneurysm in women. J Vasc Surg. 2001;34(1):122–6. doi:.https://doi.org/10.1067/mva.2001.115275
  4. Lederle FA, Johnson GR, Wilson SE, Chute EP, Littooy FN, Bandyk D, et al.; Aneurysm Detection and Management (ADAM) Veterans Affairs Cooperative Study Group. Prevalence and associations of abdominal aortic aneurysm detected through screening. Ann Intern Med. 1997;126(6):441–9. doi:.https://doi.org/10.7326/0003-4819-126-6-199703150-00004
  5. Frame PS, Carlson SJ. A critical review of periodic health screening using specific screening criteria. 3. Selected diseases of the genitourinary system. J Fam Pract. 1975;2(3):189–94.
  6. Ashton HA, Buxton MJ, Day NE, Kim LG, Marteau TM, Scott RA, et al., Multicentre Aneurysm Screening Study Group. The Multicentre Aneurysm Screening Study (MASS) into the effect of abdominal aortic aneurysm screening on mortality in men: a randomised controlled trial. Lancet. 2002;360(9345):1531–9. doi:.https://doi.org/10.1016/S0140-6736(02)11522-4
  7. Thompson SG, Ashton HA, Gao L, Scott RAP ; Multicentre Aneurysm Screening Study Group. Screening men for abdominal aortic aneurysm: 10 year mortality and cost effectiveness results from the randomised Multicentre Aneurysm Screening Study. BMJ. 2009;338(jun24 2):b2307. doi:.https://doi.org/10.1136/bmj.b2307
  8. Lindholt JS, Juul S, Fasting H, Henneberg EW. Preliminary ten year results from a randomised single centre mass screening trial for abdominal aortic aneurysm. Eur J Vasc Endovasc Surg. 2006;32(6):608–14. doi:.https://doi.org/10.1016/j.ejvs.2006.06.008
  9. Norman PE, Jamrozik K, Lawrence-Brown MM, Le MTQ, Spencer CA, Tuohy RJ, et al. Population based randomised controlled trial on impact of screening on mortality from abdominal aortic aneurysm. BMJ. 2004;329(7477):1259. doi:.https://doi.org/10.1136/bmj.38272.478438.55
  10. Mastracci TM, Cinà CS ; Canadian Society for Vascular Surgery. Screening for abdominal aortic aneurysm in Canada: review and position statement of the Canadian Society for Vascular Surgery. J Vasc Surg. 2007;45(6):1268–76. doi:.https://doi.org/10.1016/j.jvs.2007.02.041
  11. Meyer M, Dick F, Masshardt W, Willenberg T, Do D-D, Kucher N, et al. Initial results of a computerized screening alert for abdominal aortic aneurysm in patients undergoing vascular assessment. Vasa. 2013;42(3):208–13. doi:.https://doi.org/10.1024/0301-1526/a000268
  12. Powell JT, Brown LC, Forbes JF, Fowkes FGR, Greenhalgh RM, Ruckley CV, et al. Final 12-year follow-up of surgery versus surveillance in the UK Small Aneurysm Trial. Br J Surg. 2007;94(6):702–8. doi:.https://doi.org/10.1002/bjs.5778
  13. Lindholt JS, Juul S, Fasting H, Henneberg EW. Hospital costs and benefits of screening for abdominal aortic aneurysms. Results from a randomised population screening trial. Eur J Vasc Endovasc Surg. 2002;23(1):55–60. doi:.https://doi.org/10.1053/ejvs.2001.1534
  14. Corrado G, Durante A, Genchi V, Trabattoni L, Beretta S, Rovelli E, et al. Prevalence of previously undiagnosed abdominal aortic aneurysms in the area of Como: the ComoCuore “looking for AAA” ultrasonography screening. Int J Cardiovasc Imaging. 2016;32(8):1213–7. doi:.https://doi.org/10.1007/s10554-016-0911-3