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Outcomes of an abdominal aortic aneurysm screening program
Kevin C Chun1, Kai Y Teng, Elyse N Van Spyk
1Department of Surgery, Sacramento VA Medical Center, Mather, CA, USA.
Journal of Vascular Surgery
|November 13, 2012
Summary
This study evaluated a 5-year abdominal aortic aneurysm (AAA) screening program for male veterans. The program successfully identified aneurysms, and inappropriate screenings decreased over time.
Area of Science:
- Vascular Surgery
- Public Health
- Geriatrics
Background:
- Medicare guidelines established in 2007 aim to identify individuals at risk for abdominal aortic aneurysms (AAA).
- Veterans Affairs (VA) implemented a regional screening program for AAA in 2007.
- The program targeted male veterans aged 65-75 who were prior smokers.
Purpose of the Study:
- To evaluate the 5-year outcomes of an AAA screening program within a regional VA healthcare system.
- To assess the effectiveness of AAA screening protocols and referral adherence.
- To analyze trends in appropriate and inappropriate AAA screenings over time.
Main Methods:
- Retrospective data extraction from a VA healthcare network.
- Inclusion criteria: male veterans aged 65-75, history of smoking at least 100 cigarettes.
- Evaluation of clinician adherence to screening protocols and vascular surgeon referrals for aneurysms >5.5 cm.
Main Results:
- 9751 patients were screened over 5 years (2007-2011), identifying 698 aneurysms (7.1%).
- 45 patients with aneurysms >5.5 cm were referred to a vascular surgeon.
- Inappropriate screenings decreased from 39.2% in 2007 to 14.3% in 2011.
Conclusions:
- The VA AAA screening program detects aneurysms, often at smaller diameters compared to clinical trials.
- There was a significant reduction in inappropriate AAA screenings over the 5-year study period.
- Future research should focus on surveillance guidelines for small and medium-sized aneurysms.
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