부산대학교 도서관

Byline: C. Oliver-Williams, M. J. Sweeting, G. Turton, D. Parkin, D. Cooper, C. Rodd, S. G. Thompson,J. J. Earnshaw, Background This study aimed to assess how the prevalence and growth rates of small and medium abdominal aortic aneurysms (AAAs) (3ae0-5ae4cm) have changed over time in men aged 65years, and to evaluate long-term outcomes in men whose aortic diameter is 2ae6-2ae9cm (subaneurysmal), and below the standard threshold for most surveillance programmes. Methods The Gloucestershire Aneurysm Screening Programme (GASP) started in 1990. Men aged 65years with an aortic diameter of 2ae6-5ae4cm, measured by ultrasonography using the inner to inner wall method, were included in surveillance. Aortic diameter growth rates were estimated separately for men who initially had a subaneurysmal aorta, and those who had a small or medium AAA, using mixed-effects models. Results Since 1990, 81 150 men had ultrasound screening for AAA (uptake 80ae7 per cent), of whom 2795 had an aortic diameter of 2ae6-5ae4cm. The prevalence of screen-detected AAA of 3ae0cm or larger decreased from 5ae0 per cent in 1991 to 1ae3 per cent in 2015. There was no evidence of a change in AAA growth rates during this time. Of men who initially had a subaneurysmal aorta, 57ae6 (95 per cent c.i. 54ae4 to 60ae7) per cent were estimated to develop an AAA of 3ae0cm or larger within 5years of the initial scan, and 28ae0 (24ae2 to 31ae8) per cent to develop a large AAA (at least 5ae5cm) within 15years. Conclusion The prevalence of screen-detected small and medium AAAs has decreased over the past 25years, but growth rates have remained similar. Men with a subaneurysmal aorta at age 65years have a substantial risk of developing a large AAA by the age of 80years. CAPTION(S): Table S1. Estimated growth rate (cm/year) with 95% confidence intervals by initial AAA diameter, reported by duration since initial scan. Figure S1. Distribution of aortic diameters at baseline Figure S2. Adherence to recommended surveillance intervals