A Retrospective Analysis of the Clinical Effects to Ultrasound Screening for Abdominal Aortic Aneurysms: The RACE to SAAAVE Study

The Screening for Abdominal Aortic Aneurysms Very Efficiently (SAAAVE) Act authorizes Medicare to pay for an ultrasound screening for select patients. We hypothesized that the potential increase in screening would affect the ability of a high-volume medical center to respond to this need. Selection criteria included age >65 years and evidence of or risk factors for cardiovascular and/or atherosclerotic disease. We queried the medical center's information warehouse to define a patient population which, in a retrospective fashion, would have met the aforementioned criteria. We sought to quantify the potential increase in the number of abdominal aortic aneurysm (AAA) ultrasound screenings. There were 29,875 patients who met the inclusion criteria. Upon admission, 476 patients (1.5%) were diagnosed with AAA, and 35 were diagnosed with ruptured AAAs. There were 742 AAA diagnosed at time of discharge, equivalent to a 55.9% increase in prevalence of aneurysms compared with admission diagnoses. Of these, 48 were diagnosed upon discharge after rupture, which was greater than a 37% increase compared with the number diagnosed upon admission. During the study period, the medical center imaging laboratories performed an average of 1700 to 2100 ultrasound scans per full-time equivalent sonographer. Our results suggest that the additional patient volume would be approximately 10,000 patients per year. The SAAAVE Act of 2005 will have a profound impact on health care institutions nationwide.