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Abdominal aortic aneurysm screening program using hand-held ultrasound in primary healthcare.

Abdominal aortic aneurysm screening program using hand-held ultrasound in primary healthcare.
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Sisó-Almirall A, Kostov B, Navarro González M, Cararach Salami D, Pérez Jiménez A, Gilabert Solé R, Bru Saumell C, Donoso Bach L, Villalta Martí M, González-de Paz L, Ruiz Riera R, Riambau Alonso V, Acar-Denizli N, Farré Almacellas M, Ramos-Casals M, Benavent Àreu J,


Sisó-Almirall A, Kostov B, Navarro González M, Cararach Salami D, Pérez Jiménez A, Gilabert Solé R, Bru Saumell C, Donoso Bach L, Villalta Martí M, González-de Paz L, Ruiz Riera R, Riambau Alonso V, Acar-Denizli N, Farré Almacellas M, Ramos-Casals M, Benavent Àreu J, (click to view)

Sisó-Almirall A, Kostov B, Navarro González M, Cararach Salami D, Pérez Jiménez A, Gilabert Solé R, Bru Saumell C, Donoso Bach L, Villalta Martí M, González-de Paz L, Ruiz Riera R, Riambau Alonso V, Acar-Denizli N, Farré Almacellas M, Ramos-Casals M, Benavent Àreu J,

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PloS one 2017 04 2812(4) e0176877 doi 10.1371/journal.pone.0176877
Abstract

We determined the feasibility of abdominal aortic aneurysm (AAA) screening program led by family physicians in public primary healthcare setting using hand-held ultrasound device. The potential study population was 11,214 men aged ≥ 60 years attended by three urban, public primary healthcare centers. Participants were recruited by randomly-selected telephone calls. Ultrasound examinations were performed by four trained family physicians with a hand-held ultrasound device (Vscan®). AAA observed were verified by confirmatory imaging using standard ultrasound or computed tomography. Cardiovascular risk factors were determined. The prevalence of AAA was computed as the sum of previously-known aneurysms, aneurysms detected by the screening program and model-based estimated undiagnosed aneurysms. We screened 1,010 men, with mean age of 71.3 (SD 6.9) years; 995 (98.5%) men had normal aortas and 15 (1.5%) had AAA on Vscan®. Eleven out of 14 AAA-cases (78.6%) had AAA on confirmatory imaging (one patient died). The total prevalence of AAA was 2.49% (95%CI 2.20 to 2.78). The median aortic diameter at diagnosis was 3.5 cm in screened patients and 4.7 cm (p<0.001) in patients in whom AAA was diagnosed incidentally. Multivariate logistic regression analysis identified coronary heart disease (OR = 4.6, 95%CI 1.3 to 15.9) as the independent factor with the highest odds ratio. A screening program led by trained family physicians using hand-held ultrasound was a feasible, safe and reliable tool for the early detection of AAA.

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