Late survival after elective repair of aortic aneurysms detected by screening.
BACKGROUND
The aim of this study was to examine whether there was any survival advantage in men following elective repair of an abdominal aortic aneurysm (AAA) detected by ultrasound screening compared to those with an AAA detected incidentally.


METHODS
A total of 424 men underwent elective AAA repair between 1990 and 1998; 181 were detected in an aneurysm screening programme and 243 were diagnosed incidentally. Follow-up survival data were collected until 2003 (minimum 5 years) and survival curves were compared using regression analysis.


RESULTS
The postoperative 30-day mortality rate was significantly lower in men whose aneurysms were detected by screening (4.4%), compared with those detected incidentally (9.0%). Similarly, 5-year survival (78% vs. 65%) and 10-year survival rates (63% vs. 40%) were better after repair of a screen-detected AAA (p<0.0003 at all time intervals, by log rank testing). Multivariate analysis showed that this was largely due to the older age of men who had repair of an incidental AAA (71.2 vs. 67.1 years).


CONCLUSIONS
Men who had elective repair of an AAA detected by screening had a better late survival rate than men whose aneurysm was discovered incidentally because they were younger at the time of surgery.
Gloucestershire Vascular Group, Gloucestershire Royal Hospital, Great Western Road, Gloucester GL1 3NN, UK.
J C
JC
Taylor
E
E
Shaw
M R
MR
Whyman
K R
KR
Poskitt
B P
BP
Heather
J J
JJ
Earnshaw
D000368:Aged; D001014:Aortic Aneurysm / Q000401:mortality* / Q000601:surgery*; D017558:Elective Surgical Procedures; D006801:Humans; D033162:Incidental Findings; D008297:Male; D015996:Survival Rate; D013997:Time Factors