Screening for abdominal aortic aneurysm among patients referred to the vascular laboratory is cost-effective

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
Kevin ManiAnders Wanhainen

Abstract

Screening for abdominal aortic aneurysm (AAA) in high-risk groups has been recommended based on a high prevalence of disease, while being questioned due to a high frequency of co-morbidities and inferior life-expectancy. We evaluated the long-term outcome and the cost-effectiveness of selective AAA screening among patients referred to the vascular laboratory for arterial examination. A total of 5,924 patients, referred to the vascular laboratory of a university hospital, were screened for AAA with ultrasound (definition: slashed circle>or=30 mm), 1993-2005. Outcome data were gathered through hospital records and the national population registry. A Markov model was used for health-economic evaluation. An AAA was detected in 181 patients (mean age 72.8 years), of whom 21.5% underwent elective repair (perioperative mortality 5.1%) after 7.5 years of follow-up. Four of six patients diagnosed with AAA rupture were operated upon. Relative 5-year survival compared with the general Swedish population, controlled for age and sex, was 80.4% (95% confidence interval (CI): 70.8-88.8). The cost-effectiveness was robust in base-case (11,084 Euro/life year gained) and in sensitivity analyses of prevalence, cost and survival. Patients in whom ...Continue Reading

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Citations

Aug 17, 2014·The American Journal of Cardiology·Victor AboyansUNKNOWN investigators of the E2T3A study
Mar 10, 2016·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·M ZarroukA Gottsäter
Apr 23, 2011·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·S A BadgerI S Young
Oct 12, 2014·Annals of Vascular Surgery·Won Pyo ChoSeok-Hwan Shin
Oct 28, 2016·Circulation·Adam W BeckUNKNOWN International Consortium of Vascular Registries
Dec 11, 2019·JAMA : the Journal of the American Medical Association·Janelle M Guirguis-BlakeErin L Coppola
May 15, 2021·Cost Effectiveness and Resource Allocation : C/E·Rajabali DaroudiParham Sadeghipour

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