Final follow-up of the Multicentre Aneurysm Screening Study (MASS) randomized trial of abdominal aortic aneurysm screening
Final follow-up of the Multicentre Aneurysm Screening Study (MASS) randomized trial of abdominal aortic aneurysm screening
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DOI：
10.1002/bjs.8897
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发表时间：
2012-12-01
影响因子：
9.6
通讯作者：
Scott, R. A. P.
中科院分区：
文献类型：
--
作者：
Thompson, S. G.;Ashton, H. A.;Scott, R. A. P.
背景资料：腹主动脉瘤（AAA）筛查的长期影响进行了调查，在延长后续从英国多中心动脉瘤筛查研究（MASS）随机trial.Methods：一个基于人口的样本年龄为65 - 74岁的男性被随机单独邀请超声筛查（邀请组）或对照组不提供筛选。筛选时检测到AAA（3.0 cm或更大）的患者接受监测，并在满足预定标准后接受手术。使用考克斯回归分析死因特异性死亡率数据。在13年中，邀请组有224例AAA相关死亡，对照组有381例，减少了42%（95%置信区间31至51%）。没有证据表明对其他死亡原因有影响，但全因死亡率总体降低了3%（1 - 5%）。在最初几年的随访中，由于主动脉筛查正常的患者发生AAA破裂，获益程度略有降低。这些破裂中约有一半的基线主动脉直径在2.52.9 cm范围内。据估计，216名男子需要被邀请到筛选，以节省一个死亡在未来13 years.Conclusion：筛选导致全因死亡率降低，并在AAA相关的死亡率的好处继续积累整个后续行动。注册号：ISRCTN 37381646（http：www.controlled-trials.com）。版权所有（c）2012英国外科学会杂志有限公司由约翰威利父子有限公司出版。
Background: The long-term effects of abdominal aortic aneurysm (AAA) screening were investigated in extended follow-up from the UK Multicentre Aneurysm Screening Study (MASS) randomized trial.Methods: A population-based sample of men aged 6574 years were randomized individually to invitation to ultrasound screening (invited group) or to a control group not offered screening. Patients with an AAA (3.0 cm or larger) detected at screening underwent surveillance and were offered surgery after predefined criteria had been met. Cause-specific mortality data were analysed using Cox regression.Results: Some 67 770 men were enrolled in the study. Over 13 years, there were 224 AAA-related deaths in the invited group and 381 in the control group, a 42 (95 per cent confidence interval 31 to 51) per cent reduction. There was no evidence of effect on other causes of death, but there was an overall reduction in all-cause mortality of 3 (1 to 5) per cent. The degree of benefit seen in earlier years of follow-up was slightly diminished by the occurrence of AAA ruptures in those with an aorta originally screened normal. About half of these ruptures had a baseline aortic diameter in the range 2.52.9 cm. It was estimated that 216 men need to be invited to screening to save one death over the next 13 years.Conclusion: Screening resulted in a reduction in all-cause mortality, and the benefit in AAA-related mortality continued to accumulate throughout follow-up. Registration number: ISRCTN37381646 (http://www.controlled-trials.com). Copyright (c) 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.