Abdominal Aortic Aneurysm : Experience from a Screening Study in Northern Sweden
Abdominal aortic aneurysm (AAA) is a common problem with life-threatening consequences and was suspected to be a serious health problem in Norsjö, a municipality in northern Sweden. A screening study was undertaken to investigate the prevalence, risk factors associated with AAA and the effect of scr...
Main Author: | |
---|---|
Format: | Doctoral or Postdoctoral Thesis |
Language: | English |
Published: |
Uppsala universitet, Institutionen för kirurgiska vetenskaper
2004
|
Subjects: | |
Online Access: | http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4459 |
id |
ftuppsalauniv:oai:DiVA.org:uu-4459 |
---|---|
record_format |
openpolar |
spelling |
ftuppsalauniv:oai:DiVA.org:uu-4459 2023-05-15T17:44:32+02:00 Abdominal Aortic Aneurysm : Experience from a Screening Study in Northern Sweden Wanhainen, Anders 2004 application/pdf http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4459 eng eng Uppsala universitet, Institutionen för kirurgiska vetenskaper Uppsala : Acta Universitatis Upsaliensis Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, 0282-7476 1364 http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4459 urn:isbn:91-554-6008-9 info:eu-repo/semantics/openAccess Surgery abdominal aortic aneurysm definition prevalence ultrasonography computed tomography variability quality of life SF-36 risk factor cholesterol smoking CRP heredity atherosclerosis screening cost-effectiveness cost-utility Kirurgi Doctoral thesis, comprehensive summary info:eu-repo/semantics/doctoralThesis text 2004 ftuppsalauniv 2023-02-23T21:44:09Z Abdominal aortic aneurysm (AAA) is a common problem with life-threatening consequences and was suspected to be a serious health problem in Norsjö, a municipality in northern Sweden. A screening study was undertaken to investigate the prevalence, risk factors associated with AAA and the effect of screening on quality of life (QoL). All men and women, aged 65-75 years, were invited to an ultrasonography (US) examination, 91% attended and 92 subjects were also evaluated with computed tomography (CT). Depending on diagnostic criteria, the AAA prevalence was 3.6-16.9% in men and 0.8-9.4% in women. Seventy-five percent of the differences between US- and CT anteroposterior measurements were less than 5 mm. A decrease in mental health was observed among AAA patients with low baseline SF-36 scale scores. Elevated cholesterol at age 60 years were associated with screening detected AAA after 12 years of follow-up. Smoking, atherosclerosis and having a first degree relative with AAA were associated with AAA at screening. Compared to blood samples obtained 12 years prior to screening an elevation of hsCRP over time was observed among AAA patients. Based on a systematic review of the literature, different screening strategies were analysed in a Markov cohort model. The cost per life year gained ranged from $8 309 to $14 084 and was estimated to $10 474 when 65 year old men were screened once. Conclusions: The highest prevalence of AAA ever reported, in a population-based screening program, was found in Norsjö. The risk of having an AAA at screening showed a strong but complex association with atherosclerosis and its risk factors, genetic and inflammatory mechanisms may also be important. Screening 65-year-old men for AAA may be cost-effective, but QoL aspects on the cost-effectiveness of AAA screening merits further investigation. Doctoral or Postdoctoral Thesis Northern Sweden Uppsala University: Publications (DiVA) |
institution |
Open Polar |
collection |
Uppsala University: Publications (DiVA) |
op_collection_id |
ftuppsalauniv |
language |
English |
topic |
Surgery abdominal aortic aneurysm definition prevalence ultrasonography computed tomography variability quality of life SF-36 risk factor cholesterol smoking CRP heredity atherosclerosis screening cost-effectiveness cost-utility Kirurgi |
spellingShingle |
Surgery abdominal aortic aneurysm definition prevalence ultrasonography computed tomography variability quality of life SF-36 risk factor cholesterol smoking CRP heredity atherosclerosis screening cost-effectiveness cost-utility Kirurgi Wanhainen, Anders Abdominal Aortic Aneurysm : Experience from a Screening Study in Northern Sweden |
topic_facet |
Surgery abdominal aortic aneurysm definition prevalence ultrasonography computed tomography variability quality of life SF-36 risk factor cholesterol smoking CRP heredity atherosclerosis screening cost-effectiveness cost-utility Kirurgi |
description |
Abdominal aortic aneurysm (AAA) is a common problem with life-threatening consequences and was suspected to be a serious health problem in Norsjö, a municipality in northern Sweden. A screening study was undertaken to investigate the prevalence, risk factors associated with AAA and the effect of screening on quality of life (QoL). All men and women, aged 65-75 years, were invited to an ultrasonography (US) examination, 91% attended and 92 subjects were also evaluated with computed tomography (CT). Depending on diagnostic criteria, the AAA prevalence was 3.6-16.9% in men and 0.8-9.4% in women. Seventy-five percent of the differences between US- and CT anteroposterior measurements were less than 5 mm. A decrease in mental health was observed among AAA patients with low baseline SF-36 scale scores. Elevated cholesterol at age 60 years were associated with screening detected AAA after 12 years of follow-up. Smoking, atherosclerosis and having a first degree relative with AAA were associated with AAA at screening. Compared to blood samples obtained 12 years prior to screening an elevation of hsCRP over time was observed among AAA patients. Based on a systematic review of the literature, different screening strategies were analysed in a Markov cohort model. The cost per life year gained ranged from $8 309 to $14 084 and was estimated to $10 474 when 65 year old men were screened once. Conclusions: The highest prevalence of AAA ever reported, in a population-based screening program, was found in Norsjö. The risk of having an AAA at screening showed a strong but complex association with atherosclerosis and its risk factors, genetic and inflammatory mechanisms may also be important. Screening 65-year-old men for AAA may be cost-effective, but QoL aspects on the cost-effectiveness of AAA screening merits further investigation. |
format |
Doctoral or Postdoctoral Thesis |
author |
Wanhainen, Anders |
author_facet |
Wanhainen, Anders |
author_sort |
Wanhainen, Anders |
title |
Abdominal Aortic Aneurysm : Experience from a Screening Study in Northern Sweden |
title_short |
Abdominal Aortic Aneurysm : Experience from a Screening Study in Northern Sweden |
title_full |
Abdominal Aortic Aneurysm : Experience from a Screening Study in Northern Sweden |
title_fullStr |
Abdominal Aortic Aneurysm : Experience from a Screening Study in Northern Sweden |
title_full_unstemmed |
Abdominal Aortic Aneurysm : Experience from a Screening Study in Northern Sweden |
title_sort |
abdominal aortic aneurysm : experience from a screening study in northern sweden |
publisher |
Uppsala universitet, Institutionen för kirurgiska vetenskaper |
publishDate |
2004 |
url |
http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4459 |
genre |
Northern Sweden |
genre_facet |
Northern Sweden |
op_relation |
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, 0282-7476 1364 http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4459 urn:isbn:91-554-6008-9 |
op_rights |
info:eu-repo/semantics/openAccess |
_version_ |
1766146770534924288 |