Long-term Outcomes of the Western Australian Trial of Screening for Abdominal Aortic Aneurysms Secondary Analysis of a Randomized Clinical Trial
Long-term Outcomes of the Western Australian Trial of Screening for Abdominal Aortic Aneurysms Secondary Analysis of a Randomized Clinical Trial
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DOI：
10.1001/jamainternmed.2016.6633
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发表时间：
2016-12-01
影响因子：
39
通讯作者：
Norman, Paul E.
中科院分区：
文献类型：
--
作者：
McCaul, Kieran A.;Lawrence-Brown, Michael;Norman, Paul E.
腹主动脉瘤破裂（AAAs）的死亡率仍然很高。对老年男性进行AAAs筛查的益处需要在一系列卫生保健机构中进行评估。目的评价64 ~ 83岁男性AAAs筛查对AAAs死亡率的影响。设计、环境和参与者本随机临床试验于1996年4月1日至1999年3月31日进行，平均随访12.8年（11.6-14.2年），包括来自西澳大利亚单一大都市地区的基于人群的样本，通过选民名册确定。数据分析时间为2015年6月1日至2016年6月1日。干预措施随机分为两组，一组接受腹主动脉超声检查，另一组不接受超声检查。主要结果和测量：aaa患者的手术和死亡率。结果共纳入49801名年龄在64 - 83岁的男性。排除了离筛查中心太远的男性（n = 8671）或在邀请前死亡的男性（n = 2650），结果邀请组有19249名男性，对照组有19231名男性（平均[SD]年龄72.5[4.6]岁，95%为白人）。在19249名受邀接受筛查的男性中，有12203人（63.4%）参加了筛查。选择性手术较多(536例对414例，P
IMPORTANCE Mortality from ruptured abdominal aortic aneurysms (AAAs) remains high. The benefit of screening older men for AAAs needs to be assessed in a range of health care settings.OBJECTIVE To assess the influence of screening for AAAs in men aged 64 to 83 years on mortality from AAAs.DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial performed from April 1, 1996, through March 31, 1999, with a mean of 12.8 years of follow-up (range, 11.6-14.2 years) included a population-based sample from a single metropolitan region in Western Australia identified via the electoral roll. Data analysis was performed from June 1, 2015, to June 1, 2016.INTERVENTIONS Randomization to an invitation to undergo ultrasonography of the abdominal aorta or a control group without invitation.MAIN OUTCOMES AND MEASURES Surgery for and mortality from AAA.RESULTS A total of 49 801 men aged 64 to 83 years were identified for the study. Men living too far from screening centers (n = 8671) or who died before invitation (n = 2650) were excluded, resulting in 19 249 men in the invited group and 19 231 controls (mean [SD] age, 72.5 [4.6] years; 95% white). Of 19 249 men invited for screening, 12 203 (63.4%) attended. There were more elective operations (536 vs 414, P