1887
Volume 2015, Issue 1
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

The prevalence of abdominal aortic aneurysm (AAA) is 1-2 percent in the general population, and is as high as 6 percent in groups with risk factors. The aim of this study was to determine the prevalence of AAA amongst high-risk cardiac patients in the emergency department (ED). A prospective study was conducted to evaluate the prevalence of AAA in a high-risk population presenting to the ED. Inclusion criteria included male gender, Caucasian race, age over 50 years, history of smoking, and presentation to the ED with chest pain requiring admission. Patients enrolled in the study were screened for AAA by ultrasound (US) scan. Study subjects were excluded if there was inadequate imaging. One hundred and nine patients were recruited into the study. Nineteen patients were excluded by the ED US Director secondary to inadequate imaging. Of the remaining 90 patients, eight patients were found to have AAA (n = 8; 8.9%; CI 3.9 - 16.8%). Of the eight patients with an AAA, four had diagnosed cardiovascular disease during their hospital admission. There was no statistically significant difference in secondary risk factors such as hypertension, diabetes, dyslipidemia or previous history of coronary artery disease between those with AAA and those without AAA. This study found that in a single ED, the prevalence of AAA in high-risk cardiac patients admitted to rule out acute coronary syndrome who could be adequately visualized with ultrasound was over 8 percent. With such a high prevalence, this population could be a potential screening group.

Loading

Article metrics loading...

/content/journals/10.5339/jemtac.2015.2
2015-03-18
2020-09-28
Loading full text...

Full text loading...

/deliver/fulltext/jemtac/2015/1/jemtac.2015.2.html?itemId=/content/journals/10.5339/jemtac.2015.2&mimeType=html&fmt=ahah

References

  1. Latif AA, Almahameed A, Lauer MS. Should we screen for abdominal aortic aneurysms? Cleve Clin J Med. 2006; 73:9-10:13. 16-17 passim.
    [Google Scholar]
  2. Lee TY, Korn P, Heller JA, et al., The cost-effectiveness of a “quick-screen” program for abdominal aortic aneurysms. Surgery. 2002; 132::399407.
    [Google Scholar]
  3. Blanchard JF. Epidemiology of abdominal aortic aneurysms. Epidemiol Rev. 1999; 21::207221.
    [Google Scholar]
  4. Sherman Fredrick T. Screening for abdominal aortic aneurysms in the elderly. Geriatrics. 2008; 63::1516.
    [Google Scholar]
  5. Ashton HA, Buxton MJ, Day NE, et al., The multicentre aneurysm screening study (MASS) into the effect of abdominal aortic aneurysm screening on mortality in men: A randomised controlled trial. Lancet. 2002; 360::15311539.
    [Google Scholar]
  6. Cornuz J, Sidoti Pinto C, Tevaearai H, Egger M. Risk factors for asymptomatic abdominal aortic aneurysm: Systematic review and meta-analysis of population-based screening studies. Eur J Public Health. 2004; 14::343349.
    [Google Scholar]
  7. Van Kuijk JP, Flu WJ, Dunckelgrun M, Bax JJ, Poldermans D. Coronary artery disease in patients with abdominal aortic aneurysm: A review article. J Cardiovasc Surg (Torino). 2009; 50::93107.
    [Google Scholar]
  8. Fleming C, Whitlock EP, Beil TL, Lederle FA. Screening for abdominal aortic aneurysm: A best-evidence systematic review for the U.S. preventive services task force. Ann Intern Med. 2005; 142::203211.
    [Google Scholar]
  9. Takagi H, Goto SN, Matsui M, Manabe H, Umemoto T. A further meta-analysis of population-based screening for abdominal aortic aneurysm. J Vasc Surg. 2010; 52::11031108.
    [Google Scholar]
  10. Madaric J, Vulev I, Bartunek J, et al., Frequency of abdominal aortic aneurysm in patients >60 years of age with coronary artery disease. Am J Cardiol. 2005; 96::12141216.
    [Google Scholar]
  11. Nakayama A, Morita H, Miyata T, et al., Inverse association between the existence of coronary artery disease and progression of abdominal aortic aneurysm. Atherosclerosis. 2012; 222::278283.
    [Google Scholar]
  12. Costantino TG, Bruno EC, Handly N, Dean AJ. Accuracy of emergency medicine ultrasound in the evaluation of abdominal aortic aneurysm. J Emerg Med. 2005; 29::455460.
    [Google Scholar]
  13. Earnshaw JJ, Shaw E, Whyman MR, Poskitt KR, Heather BP. Screening for abdominal aortic aneurysms in men. BMJ. 2004; 328::11221124.
    [Google Scholar]
  14. Phelan MP, Emerman CL. Focused aortic ultrasound to evaluate the prevalence of abdominal aortic aneurysm in ED patients with high-risk symptoms. Am J Emerg Med. 2006; 24::227229.
    [Google Scholar]
  15. Hoffmann B, Um P, Bessman ES, Ding R, Kelen GD, McCarthy ML. Routine screening for asymptomatic abdominal aortic aneurysm in high-risk patients is not recommended in emergency departments that are frequently crowded. Acad Emerg Med. 2009; 16::12421250.
    [Google Scholar]
  16. Salen P, Melanson S, Buro D. ED screening to identify abdominal aortic aneurysms in asymptomatic geriatric patients. Am J Emerg Med. 2003; 21::133135.
    [Google Scholar]
  17. Moore CL, Holliday RS, Hwang JQ, Osborne MR. Screening for abdominal aortic aneurysm in asymptomatic at-risk patients using emergency ultrasound. Am J Emerg Med. 2008; 26::883887.
    [Google Scholar]
  18. Woolard R, Degutis LC, et al., Public Health in the Emergency Department: Surveillance, Screening and Intervention – Funding and Sustainability. Acad Emerg Med. 2009; 16:11:11381142.
    [Google Scholar]
  19. McCaig L, Burt C. National Hospital Ambulatory Medical Care Survey: 2003 Emergency Department Summary. In: Advance Data from Vital and Health Statistics. Centers for disease control and prevention, Atlanta, GA, 2005.
    [Google Scholar]
  20. Gindi RM, Cohen RA, Kirzinger WK. Emergency room use among adults aged 18–64: Early release of estimates from the National Health Interview Survey, January–June 2011. National Center for Health Statistics. May 2012.
  21. Talley BE, Ginde AA, Raja AS, Sullivan AF, Espinola JA, Camargo CA. Variable access to immediate bedside ultrasound in the Emergency Department. West J Emerg Med. 2011; 12:1:9699.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/jemtac.2015.2
Loading
/content/journals/10.5339/jemtac.2015.2
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): abdominal aortic aneurysm , emergency ultrasound and high-risk cardiac patients
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error