Key result
An adjusted annual abdominal aortic aneurysm growth rate of at least 2 mm significantly predicted AAA-related events, with growth rates of 2.99 mm/year for elective surgery and 2.85 mm/year for rupture compared to 1.08 mm/year for continued surveillance.
Cohort (n=1,231)
No
Absolute Event Rate: 2.99% vs 1.08%
p-value: p=<0.001
An annual AAA growth rate of at least 2 mm is a significant predictor of AAA-related events (surgery or death), which may help better target screening and surveillance.
May refine AAA surveillance intensity in higher-growth patients; leaves open outcome impact without prospective validation.
BACKGROUND: This retrospective analysis of prospectively collected abdominal aortic aneurysm (AAA) screening data aimed to identify predictors of AAA-related events (surgery or death) with a view to better targeting of screening. METHODS: For the interval 1984-2007, data for 1649 subjects with an AAA were collected prospectively as part of the Chichester AAA screening programme. This included serial aortic size measurements, blood pressure, risk factors for arterial disease and concurrent medications. AAA growth rates were adjusted for risk factor confounders using flexible hierarchical modelling. AAA growth distribution was analysed using Silverman's test of multimodality. RESULTS: Some 1231 subjects met the inclusion criteria of having more than one scan and a surveillance interval of over 3 months. AAA growth showed a bimodal pattern with nearly 50 per cent of all aneurysms never progressing to surgery or rupture. Adjusted annual AAA growth rates of at least 2 mm significantly predicted AAA-related events. CONCLUSION: This analysis identified a bimodal growth pattern for AAA, with a significant association between annual AAA growth rate of at least 2 mm and AAA-related events.
No takes yet. Share an insight, caveat, or question.
Thompson et al. (2009) conducted a cohort in Abdominal aortic aneurysm (AAA) (n=1,231). Abdominal aortic aneurysm (AAA) growth vs. Continued surveillance without events was evaluated on Adjusted annual AAA growth rate in subjects requiring elective surgery compared to those under continued surveillance (p=<0.001). An adjusted annual abdominal aortic aneurysm growth rate of at least 2 mm significantly predicted AAA-related events, with growth rates of 2.99 mm/year for elective surgery and 2.85 mm/year for rupture compared to 1.08 mm/year for continued surveillance.
Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context: