[Abdominal aortic aneurysm ultrasound screening in men with risk factors in Primary Care]

Aten Primaria. 2022 Mar;54(3):102234. doi: 10.1016/j.aprim.2021.102234. Epub 2021 Dec 15.
[Article in Spanish]

Abstract
in English, Spanish

Objective: to describe the implantation of ultrasound screening for Abdominal Aortic Aneurysm (AAA) in our healthcare district in men from 65 to 79 years of age who have had an identifiable risk factor for developing AAA, such as smoking or a history thereof, hypertension, family history of aneurysms, aneurysms in other locations and clinical atherosclerosis, acute myocardial infarction, intermittent claudication, or stroke. Analyse the performance of said screening.

Setting: Primary Care.

Participants and interventions: 656 patients were screened, representing 40% of the target population of 1,658 patients. The remaining part of the target population could not be screened because of the outbreak of the COVID-19 pandemic. 608 ultrasound examinations were performed.

Main measurements: coverage of the screening programme, prevalence of abdominal aortic aneurysms, prevalence of smoking and other risk factors in patients with/without aneurysms.

Results: 19 patients with ectatic aorta (25-29mm) and 11 with abdominal aortic aneurysms (1.81%) were found. 5 were active smokers (45%, compared to 20% in the entire sample) and 6 were former smokers. None of the aneurysm patients were non-smokers. 7 of them were hypertensive.

Conclusions: The prevalence of aneurysms in our sample was 2.6%, which was lower than expected. The wide use of ultrasound and its progressive generalisation in the Primary Care setting should lead to a decrease in the number of undiagnosed AAA.

Objetivo: Describir la implantación de cribado ecográfico de aneurisma de aorta abdominal (AAA) en nuestra zona básica a los varones entre 65 y 79 años y que tuviera algún factor de riesgo identificable para desarrollar AAA: tabaquismo o antecedentes del mismo, hipertensión, antecedentes familiares de aneurisma, aneurisma en otras localizaciones y ateroesclerosis clínica: infarto agudo de miocardio, claudicación intermitente o ictus. Analizar el rendimiento de dicho cribado.

Emplazamiento: Atención Primaria.

Participantes e intervenciones: Se ofreció cribado a 656 pacientes, lo que supone un 40% de la población diana de 1.658 pacientes, al tener que interrumpirse prematuramente por la pandemia COVID-19 y se realizaron 608 exploraciones ecográficas.

Mediciones principales: Cobertura del programa de cribado, prevalencia de aneurismas de aorta abdominal, prevalencias de tabaquismo y otros factores de riesgo en pacientes con/sin aneurisma.

Resultados: Se encontraron 19 pacientes con aortas ectásicas (25-29 mm) y 11 con aneurismas de aorta abdominal (1,81%). Cinco eran fumadores activos (45%, frente al 20% de toda la muestra) y seis eran exfumadores. Ninguno de los pacientes con aneurisma era no fumador. Siete de ellos eran hipertensos.

Conclusiones: La prevalencia de aneurismas en nuestra muestra se situó en el 2,6%, siendo más baja de lo esperada. La amplia utilización de la ecografía y la progresiva generalización de la misma en el ámbito de la Atención Primaria debería suponer una disminución en el número de AAA sin diagnosticar.

Keywords: Aneurisma; Aneurysm; Aorta; Aortic; Cribado; Ecografía; Screening; Ultrasound.

MeSH terms

  • Aortic Aneurysm, Abdominal* / diagnostic imaging
  • Aortic Aneurysm, Abdominal* / epidemiology
  • Aortic Aneurysm, Abdominal* / etiology
  • COVID-19*
  • Humans
  • Male
  • Mass Screening
  • Pandemics
  • Prevalence
  • Primary Health Care
  • Risk Factors
  • SARS-CoV-2
  • Ultrasonography