Risk of Developing an Abdominal Aortic Aneurysm after Ectatic Aorta Detection from Initial Screening
| Autor: | Zachary T. Irwin, Kevin C. Chun, Richard C. Anderson, Kanika Sood, Hunter C. Smothers, Machelle D. Wilson, Eugene S. Lee |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
Time Factors Cost-Benefit Analysis 030204 cardiovascular system & hematology Cardiovascular Medical and Health Sciences California Pulmonary Disease Chronic Obstructive 0302 clinical medicine Risk Factors Prevalence 030212 general & internal medicine Aorta Abdominal AAA AAA screening Aorta Ultrasonography Smoking Ectatic aorta Health Services Abdominal aortic aneurysm Aortic Aneurysm Disease Progression cardiovascular system Biomedical Imaging Radiology Aortic diameter Cardiology and Cardiovascular Medicine Dilatation Pathologic medicine.medical_specialty Chronic Obstructive Aortic Rupture Pulmonary disease Risk Assessment Article Pulmonary Disease 03 medical and health sciences Rare Diseases Predictive Value of Tests Clinical Research Chart review medicine.artery Ectasia medicine Humans Abdominal Risk factor Retrospective Studies Aged Pathologic business.industry Proportional hazards model Prevention medicine.disease Dilatation Good Health and Well Being Cardiovascular System & Hematology Surgery business Aortic Aneurysm Abdominal |
| Zdroj: | J Vasc Surg Journal of vascular surgery, vol 71, iss 6 |
| Popis: | ObjectiveCurrent abdominal aortic aneurysm (AAA) surveillance guidelines lack any follow-up recommendations after initial abdominal aortic screening diameter of less than 3.0cm. Some reports have demonstrated patients with late AAA formation and late ruptures after initial ultrasound screening detection of patients with an aortic diameter of 2.5 to 2.9cm (ectatic aorta). The purpose of this study was to determine ectatic aorta prevalence, AAA development, rupture risk, and risk factor profile in patients with detected ectatic aortas in a AAA screening program.MethodsA retrospective chart review of all patients screened for AAA from January 1, 2007, to December 31, 2016, within a regional health care system was conducted. Screening criteria were men 65 to 75years of age that smoked a minimum of 100 cigarettes in their lifetime. An ectatic aorta was defined as a maximum aortic diameter from 2.5 to 2.9cm. An AAA was defined as an aortic diameter of 3cm or greater. Patients screened with ectatic aortas who had subsequent follow-up imaging of the aorta with a minimum of 1-year follow-up were analyzed for associated clinical and cardiovascular risk factors. All data were collected through December 3,/2018. A logistic regression of statistically significant variables from univariate and χ2 analyses were performed to identify risks associated with the development of AAA from an initially diagnosed ectatic aorta. A Cox proportional hazard model was used to assess survival data. A P value of less than .05 was considered statistically significant.ResultsFrom a screening pool of 19,649 patients, 3205 (16.3%) with a mean age of 72.1± 5.3years were identified to have an ectatic aorta from January 1, 2007, to December 31, 2016. The average screening ectatic aortic diameter was 2.6± 0.1cm. There were 672 patients (21.0%) with a mean age of 73.0± 5.7years who received subsequent imaging for other clinical indications and 193 of these patients (28.7%) with ectatic aortas developed an AAA from the last follow-up scan (4.2± 2.5years). The average observation length of all patients was 6.4± 2.9years. No ruptures were reported, but 27.8% of deaths were of unknown cause. One patient had aortic growth to 5.5cm or greater (0.15%). Larger initial screening diameter (P< .01), presence of chronic obstructive pulmonary disease (P< .01), and active smoking (P= .01) were associated with AAA development.ConclusionsPatients with diagnosed ectatic aortas from screening who are active smokers or have chronic obstructive pulmonary disease are likely to develop an AAA. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|