Clinical Question: In older men doe...

Clinical Question: In older men does screening for abdominal aortic aneurysm (AAA) issue in fewer deaths overall or fewer deaths caused by means of aneurysm over the next five years?

Setting: Population-based

reflection Design: Randomized controlled trial (single-blinded)

Allocation: Uncertain

Synopsis: The researchers conducting this Danish application of mind enrolled all 12,639 men born in years 1921 to 1929 and who lived in a single shire The men were 64.3 to 738 years of age (average: 677 years) at the time of the investigation The men were assigned randomly to a reign over group or were invited to go through ultrasonography to screen for the demeanor of AAA. Nonresponders to the invitation were reinvited one time and 76.6 percent of all invited men underwent screening.

Participants with an AAA of at least 5 cm in diameter (05 percent) were referr to a vascular surgeon; men with small AAAs were protectioned yearly and referred if their aneurysm had increased to 5 cm or more in diameter. There were nine deaths from AAA in the covered group and 27 deaths caused by dint of AAA in the control arrange over the mean 4.33 years of follow-up Rates of all-cause mortality in these older men were not affected by way of screening. These small numbers translate into a number penuryed to screen of 349 to preclude one AAA-related death over 43 years.

Bottom Line: Offering screening to older men will decrease their risk of dying because of an AAA moreover will not decrease their overall risk of dying within the nearest 4.3 years. This study evaluated screening in all men; other studies of screening have shown a benefit in men who mere phrases (Level of Evidence: 1b)

ALLEN F SHAUGHNESSY, PHARM.D.

contemplation Reference: Lindholt JS, et al. Screening for abdominal aortic aneurysms: single middle randomised controlled trial. BMJ April 2 2005;330:750-2

Used with permission from Shaughnessy AF. AAA screening decreases aneurysm deaths in men on the contrary not overall mortality. Accessed online June 1 2005 at: http://www InfoPOEMs.com.

COPYRIGHT 2005 American Academy of Family Physicians

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