title: Missed opportunities for the detection of abdominal aortic aneurysms.
abstract: OBJECTIVE
  To determine whether patients attending as emergencies with ruptured AAA could have been detected opportunistically prior to rupture.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  The notes of patients attending hospital with ruptured abdominal aortic aneurysms to four City and DGH hospital in the West of Scotland were examined for previous assessments or investigations with the potential to discover an AAA.
  
  
  RESULTS
  In this series 77% of patients were not previously known to have and AAA. Of these patients 76% had been reviewed in hospital during the preceding 5 years on a combined total of 355 occasions. 56% of patients had been seen in hospital during the year preceding rupture on a total of 80 occasions, only undergoing 17 abdominal examinations.
  
  
  CONCLUSIONS
  Clinical examination is not frequently considered in routine practice as a screening tool for AAA but patients who subsequently go on to attend as an emergency ruptured AAA are likely to have consulted medical staff during the preceding years. A large number of patients have missed a prior opportunity for detection.
authors.affiliation: Department of Surgery, Southern General Hospital, 1345 Govan Road, Glasgow G51 4TF, United Kingdom. alisdair.macdonald@rah.scot.nhs.uk
authors.forename: A J
authors.initials: AJ
authors.lastname: Macdonald
authors.forename: O
authors.initials: O
authors.lastname: Faleh
authors.forename: G
authors.initials: G
authors.lastname: Welch
authors.forename: S
authors.initials: S
authors.lastname: Kettlewell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D001019:Aortic Rupture / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D042241:Early Diagnosis; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012606:Scotland / Q000453:epidemiology; D014656:Vascular Surgical Procedures