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Abdominal Aortic Screening Is a Priority for Health in Smoker Males: A Study on Central Italian Population

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  • Emma Altobelli

    (Department of Life, Public Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy)

  • Filippo Gianfelice

    (Vascular Surgery, G. Mazzini di Teramo Hospital, Local Health Unit, 64100 Teramo, Italy)

  • Paolo Matteo Angeletti

    (Department of Life, Public Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
    Rianimazione e TIPO Cardiochirurgica, Ospedale G. Mazzini, Local Health Unit, 64100 Teramo, Italy)

  • Reimondo Petrocelli

    (S. Timoteo Hospital, ASREM, 86100 Campobasso, Italy)

Abstract

Abdominal aortic aneurysm (AAA) is a major public health problem. In the last decade, in some European countries, abdominal aortic screening (AAS) is emerging as a potential prevention for the rupture of AAA. The goals of our study were to estimate AAA prevalence and risk factors in males and females in a central Italian population, also defining the cost-effectiveness of AAS programs. A pilot study screening was conducted between 1 January 2015 and 31 December 2019 in the municipality of Teramo (Abruzzo Region, Italy) in a group of men and women, ranging from the age of 65 to 79, who were not previously operated on for AAA. The ultrasound was performed by means of Acuson sequoia 512 Simens with a Convex probe. The anterior posterior of the infra-renal aorta was evaluated. The odds ratio values (ORs) were used to evaluate the risk of AAA, and the following determinants were taken into consideration: gender, smoke use, hypertension, and ischemic heart disease. We also estimated the direct costs coming from aneurysmectomy (surgical repair or endovascular aneurysms repair—EVAR). A total of 62 AAA (2.7%, mean age 73.8 ± 4.0) were diagnosed, of which 57 were in men (3.7%, mean age 73.6 ± 4.0) and 5 were in women (0.7%, mean age 74.3 ± 4.1). Male gender and smoke use are more important risk factors for AAA ≥ 3 cm, respectively: OR = 5.94 (2.37–14.99, p < 0.001) and OR = 5.21 (2.63–10.30, p < 0.000). A significant increase in OR was noted for AAA ≥ 3 cm and cardiac arrhythmia and ischemic heart disease, respectively: OR = 2.81 (1.53–5.15, p < 0.000) and OR = 2.76 (1.40–5.43, p = 0.006). Regarding the cost analysis, it appears that screening has contributed to the reduction in costs related to urgency. In fact, the synthetic indicator given by the ratio between the DRGs (disease related group) relating to the emergency and those of the elective activity went from 1.69 in the year prior to the activation of the screening to a median of 0.39 for the five-year period of activation of the screening. It is important to underline that the results of our work confirm that the screening activated in our territory has led to a reduction in the expenditure for AAA emergency interventions, having increased the planned interventions. This must be a warning for local stakeholders, especially in the post-pandemic period, in order to strengthen prevention.

Suggested Citation

  • Emma Altobelli & Filippo Gianfelice & Paolo Matteo Angeletti & Reimondo Petrocelli, 2022. "Abdominal Aortic Screening Is a Priority for Health in Smoker Males: A Study on Central Italian Population," IJERPH, MDPI, vol. 19(1), pages 1-10, January.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:1:p:591-:d:718190
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    References listed on IDEAS

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    1. Emma Altobelli & Leonardo Rapacchietta & Valerio F. Profeta & Roberto Fagnano, 2018. "Risk Factors for Abdominal Aortic Aneurysm in Population-Based Studies: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 15(12), pages 1-19, December.
    2. Emma Altobelli & Paolo Matteo Angeletti & Leonardo Rapacchietta & Reimondo Petrocelli, 2019. "Overview of Meta-Analyses: The Impact of Dietary Lifestyle on Stroke Risk," IJERPH, MDPI, vol. 16(19), pages 1-22, September.
    3. Emma Altobelli & Leonardo Rapacchietta & Paolo Matteo Angeletti & Luca Barbante & Filippo Valerio Profeta & Roberto Fagnano, 2017. "Breast Cancer Screening Programmes across the WHO European Region: Differences among Countries Based on National Income Level," IJERPH, MDPI, vol. 14(4), pages 1-24, April.
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