[Hospital costs and benefits of screening for abdominal aortic aneurysm. Results from a randomized screening trial].
BACKGROUND
The hospital costs and benefits of screening older males for abdominal aortic aneurysms (AAA) are unknown.


METHODS
In 1994, a hospital-based screening trial of 12,658 65-73-year-old males in the County of Viborg, Denmark, was started. AAA > 5 cm were referred for surgery. The remaining AAA were offered annual control scans. Those with aortic ectasia (def.: 2.5-2.9 cm) were rescreened at 5-year intervals. AAA-operations and deaths of AAA at hospital were registered. Finally, costs of screening, surveillance, and treatment were registered. Data on causes of death outside hospitals could not be obtained.


RESULTS
The attendance rate was 76%, of whom 191 (4.0%) had AAA. The average observation time was 5.13 years. 60 in the screened and 41 in the control group were operated (P = 0.06), 7 and 27 were operated as an emergency (P < 0.001), and 6 and 19 died at the hospitals due to AAA (p = 0.009). The costs per scan were 83.50 DKK, 81,400 DKK per elective operation (71,485 DKK after screening), and 117,000 DKK for an emergency operation. The costs per prevented hospital death were 67,855 DKK or approx. 7,540 DKK per life year saved (1 GBP = 12 DKK).


CONCLUSIONS
Screening older males for AAA in Denmark seems very cost-effective and reduces hospital mortality of AAA by 68% and probably the overall AAA-specific mortality by 73%.
Lindholt
Jes S
JS
Viborg-Kjellerup Sygehus, organkirurgisk afdeling, karkirurgisk sektion. Aarhus Universitet, Institut for Epidemiologi og Socialmedicin. jslindholt@mail.tele.dk
Juul
Svend
S
Fasting
Helge
H
Vammen
Sten
S
Henneberg
Eskild W
EW
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis* / Q000191:economics* / Q000401:mortality / Q000601:surgery; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003718:Denmark; D004630:Emergencies / Q000191:economics; D017721:Hospital Costs; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics*