Prevalence and associations of abdominal aortic aneurysm detected through screening
Prevalence and associations of abdominal aortic aneurysm detected through screening
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DOI：
10.7326/0003-4819-126-6-199703150-00004
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发表时间：
1997-03-15
影响因子：
39.2
通讯作者：
Ballard, DJ
中科院分区：
文献类型：
--
作者：
Lederle, FA;Johnson, GR;Ballard, DJ
背景：在对大量患者进行的多变量分析中，腹主动脉瘤(AAA)的独立危险因素尚未明确定义。目的：确定与腹主动脉瘤(AAA)独立相关的因素，并确定以前未被识别的AAA在已定义的人口学和危险人群中的患病率。设计：横断面筛查研究。地点：15个退伍军人事务部医疗中心。参与者：73 451名50~79岁，无AAA病史的退伍军人。测量：对AAA的超声筛查结果和预筛选问卷进行多因素Logistic回归分析。结果：AAA为4.0 cm或4.0 cm在1031名参与者中检测到更大的(1.4%)。吸烟是与AAA关联最强的危险因素；AAA大于或等于4.0 cm的优势比(OR)为5.57(95%可信区间为4.24~7.31)。吸烟与AAA的关联性随着吸烟年限的增加而显著增加，随着戒烟年限的增加而显著降低。在研究样本中，与吸烟相关的过度流行占所有大于或等于4.0厘米的AAA的78%。女性(OR，0.22[CI，0.07~0.68])、黑人(OR，0.49[CI，0.35~0.69])、糖尿病(OR，0.54[CI，0.44~0.65])与AAA呈负相关。AAA家族史与AAA呈正相关(OR，1.95[CI，1.56~2.43])，但只有5.1%的参与者报告了AAA。其他独立相关因素包括年龄、身高、冠状动脉疾病、动脉粥样硬化、高胆固醇水平和高血压。吸烟是与AAA最相关的危险因素，可能是大多数临床上以前未诊断出的AAA的重要病例的原因。
Background: Independent risk factors for abdominal aortic aneurysm (AAA) have not been clearly defined in multivariable analyses of large patient populations.Objective: To identify factors that are independently associated with AAA and to determine the prevalence of previously unrecognized AAA in defined demographic and risk groups.Design: Cross-sectional screening study.Setting: 15 Department of Veterans Affairs medical centers.Participants: 73 451 veterans who were 50 to 79 years of age and had no history of AAA.Measurements: The results of ultrasonographic screening for AAA and a prescreening questionnaire were analyzed using multiple logistic regression.Results: An AAA of 4.0 cm or larger was detected in 1031 participants (1.4%). Smoking was the risk factor most strongly associated with AAA; the odds ratio (OR) for AAAs of 4.0 cm or larger compared with normal aortas (infrarenal aortic diameter < 3.0 cm) was 5.57 (95% CI, 4.24 to 7.31). The association between smoking and AAA increased significantly with the number of years of smoking and decreased significantly with the number of years after quitting smoking. The excess prevalence associated with smoking accounted for 78% of all AAAs that were 4.0 cm or larger in the study sample. Female sex (OR, 0.22 [CI, 0.07 to 0.68]), black race (OR, 0.49 [CI, 0.35 to 0.69]), and presence of diabetes (OR, 0.54 [CI, 0.44 to 0.65]) were negatively associated with AAA. A family history of AAA was positively associated with AAA (OR, 1.95 [CI, 1.56 to 2.43]) but was reported by only 5.1% of participants. Other independently associated factors included age, height, coronary artery disease, any atherosclerosis, high cholesterol levels, and hypertension.Conclusions: Abdominal aortic aneurysm is associated with multiple factors. Smoking was the risk factor most strongly associated with AAA and may be responsible for most clinically important cases of previously undiagnosed AAA.