Are screening guidelines for abdominal aortic aneurysms being implemented within a large VA primary health care system?
BACKGROUND
Screening men aged 65 to 75 years who have ever smoked for abdominal aortic aneurysm (AAA) has been recommended to reduce AAA-related mortality. However, it is unknown whether the evidence-based recommendation has been implemented within primary care.


OBJECTIVE
The aim of this study was to determine whether screening for AAA is being performed within a large Veterans Affairs (VA) primary health care system.


METHODS
This was a retrospective cohort study examining AAA screening practices within the VA Connecticut Healthcare System. Any of the following imaging procedures were considered screening tests for AAA: abdominal ultrasound, computed tomography (CT) of the abdomen, CT colography, or magnetic resonance imaging of the abdomen.


RESULTS
A total of 279 patients were included in the cohort: 83 (30%) were offered screening for AAA or had recent imaging performed that would have allowed for detection of an AAA. Seventy-three patients (26%) underwent AAA screening or had recent imaging of their abdomens, while 10 patients either refused imaging or were awaiting ultrasonographic screening at the time of this study. Of the 73 patients who had undergone screening or other abdominal imaging evaluations, 9 (12.3%) were found to have AAAs.


CONCLUSIONS
There appears to be a low rate of screening for AAA within 1 primary care setting in a large VA health care system. If this finding is replicated within other VA primary health care settings, then the VA health care system should consider implementing a performance metric within primary care to improve AAA screening rates.
Federman
Daniel G
DG
VA Connecticut Health Care System, West Haven, CT 06516, USA. daniel.federman@va.gov
Carbone
Vera G
VG
Kravetz
Jeffrey D
JD
Kancir
Sue
S
Kirsner
Robert S
RS
Bravata
Dawn M
DM
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis*; D003237:Connecticut; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D016347:Medical Records Systems, Computerized; D015337:Multicenter Studies as Topic; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014481:United States; D014493:United States Department of Veterans Affairs