title: [Feasibility of hand-held-ultrasonography in the screening of abdominal aortic aneurysms and abdominal aortic atherosclerosis].
abstract: OBJECTIVE
  To determine the prevalence of abdominal aortic aneurysm (AAA) and abdominal aortic atheromatosis (AA-At) using a hand-held ultrasound by a general practitioner in the public Primary Health Care system.
  
  
  METHODS
  Pilot study that prospectively studied a cohort of men over 50 years with cardiovascular risk factors: active smokers, former smokers, or hypertensive patients, attended in primary health care center. The general practitioner completed an ultrasonography training in an Ultrasound Unit under supervision of experienced radiologists using an standard ultrasound equipment and hand-held ultrasound (VScan(®), General Electric, USA). One hundred and six patients participated in the study and all imaging data recorded were blindly evaluated by a radiologist in order to establish the concordance in the interpretation of images between general practitioner and radiologist. The kappa index was calculated to study the agreement on the presence or absence of AAA and AA-At.
  
  
  RESULTS
  We observed a prevalence of 5.88% of AAA. Kappa index for concordance in AAA diagnosis was absolute (κ = 1.0), with a sensitivity and specificity of 100%. Otherwise, the general practitioner identified 59 patients (58.4%) with AA-At, while radiologist identified 39 (38.6%) in the image review, with moderate concordance (κ = .435), sensitivity 89.74% and specificity 57.14%. Hypercholesterolemia (odds ratio [OR] 2.61; 95% confidence interval [95% CI] 0.92-7.39) and diabetes mellitus (OR 3.35; 95%CI 0.89-12.55) were independent risk factors for AA-At development in logistic regression.
  
  
  CONCLUSIONS
  After an adequate training in ultrasonography, hand-held ultrasound is a useful tool for AAA screening in Primary Care. Its simplicity, security, validity, cost-effectiveness and acceptance by the general population, makes it a feasible tool for cardiovascular risk assessment.
authors.affiliation: Centro de Salud Les Corts, Consorci d'Atenció Primària de Salut l'Eixample (CAPSE), Grupo Transversal de Investigación en Atención Primaria, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España. Electronic address: asiso@clinic.ub.es.
authors.forename: Antoni
authors.initials: A
authors.lastname: Sisó-Almirall
authors.forename: Rosa
authors.initials: R
authors.lastname: Gilabert Solé
authors.forename: Concepció
authors.initials: C
authors.lastname: Bru Saumell
authors.forename: Belchin
authors.initials: B
authors.lastname: Kostov
authors.forename: Minerva
authors.initials: M
authors.lastname: Mas Heredia
authors.forename: Luis
authors.initials: L
authors.lastname: González-de Paz
authors.forename: Laura
authors.initials: L
authors.lastname: Sebastián Montal
authors.forename: Jaume
authors.initials: J
authors.lastname: Benavent Àreu
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000453:epidemiology; D001018:Aortic Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005188:False Negative Reactions; D005189:False Positive Reactions; D005194:Family Practice; D005240:Feasibility Studies; D058005:General Practitioners; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D050177:Overweight / Q000453:epidemiology; D010865:Pilot Projects; D019095:Point-of-Care Systems; D015995:Prevalence; D011446:Prospective Studies; D011871:Radiology; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D012907:Smoking / Q000453:epidemiology; D018615:Ultrasonography, Doppler, Color / Q000295:instrumentation*
keywords: Abdominal aortic aneurysm; Abdominal aortic atherosclerosis; Aneurisma abdominal aórtico; Ateromatosis de aorta abdominal; Cardiovascular risk; Ecografía portátil; Estetoscopio ultrasónico; Hand-held ultrasonography; Riesgo cardiovascular; Ultrasonic stethoscope