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Outcome of the Swedish Nationwide Abdominal Aortic Aneurysm Screening Program
- Source :
- Circulation. 134:1141-1148
- Publication Year :
- 2016
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2016.
-
Abstract
- Background: A general abdominal aortic aneurysm (AAA) screening program, targeting 65-year-old men, has gradually been introduced in Sweden since 2006 and reached nationwide coverage in 2015. The aim of this study was to determine the outcome of this program. Methods: Data on the number of invited and examined men, screening-detected AAAs, AAAs operated on, and surgical outcome were retrieved from all 21 Swedish counties for the years 2006 through 2014. AAA-specific mortality data were retrieved from the Swedish Cause of Death Registry. A linear regression analysis was used to estimate the effect on AAA-specific mortality among all men ≥65 years of age for the observed time period. The long-term effects were projected by using a validated Markov model. Results: Of 302 957 men aged 65 years invited, 84% attended. The prevalence of screening-detected AAA was 1.5%. After a mean of 4.5 years, 29% of patients with AAA had been operated on, with a 30-day mortality rate of 0.9% (1.3% after open repair and 0.3% after endovascular repair, P P =0.020). The number needed to screen and the number needed to operate on to prevent 1 premature death were 667 and 1.5, respectively. With a total population of 9.5 million, the Swedish national AAA-screening program was predicted to annually prevent 90 premature deaths from AAA and to gain 577 quality-adjusted life-years. The incremental cost-efficiency ratio was estimated to be €7770 per quality-adjusted life-years. Conclusions: Screening 65-year-old men for AAA is an effective preventive health measure and is highly cost-effective in a contemporary setting. These findings confirm the results from earlier randomized controlled trials and model studies in a large population-based setting of the importance for future healthcare decision making.
- Subjects :
- medicine.medical_specialty
Aorta
business.industry
030204 cardiovascular system & hematology
medicine.disease
Abdominal aortic aneurysm
Surgery
Abdominal aortic aneurysm screening
03 medical and health sciences
0302 clinical medicine
Aneurysm
Physiology (medical)
medicine.artery
medicine
030212 general & internal medicine
Ultrasonography
Cardiology and Cardiovascular Medicine
business
Mass screening
Cause of death
Subjects
Details
- ISSN :
- 15244539 and 00097322
- Volume :
- 134
- Database :
- OpenAIRE
- Journal :
- Circulation
- Accession number :
- edsair.doi...........82e1dd7d7489e3eca8b9ee19b341839b