title: Screening of COPD patients for abdominal aortic aneurysm.
abstract: OBJECTIVE
  Screening for abdominal aortic aneurysm (AAA) in "men aged over 65 years who have ever smoked" is a recommended policy. To reduce the number of screenings, it may be of value to define subgroups with a higher prevalence of AAA. Since chronic obstructive pulmonary disease (COPD) and AAA are associated with several common risk factors, this study investigates the prevalence of AAA in COPD patients.
  
  
  METHODS
  Patients with COPD were identified via the hospital information system. Inclusion criteria were: COPD stage I-IV, ability to give full consent, and age >18 years; exclusion criteria were: patient too obese for an ultrasound check, previously diagnosed AAA, prior surgery for AAA, or ethical grounds such as concomitant advanced malignant or end-stage disease. The primary endpoint of the study was an aortic diameter measured by ultrasound of ≥30 mm. Defined secondary endpoints were evaluated on the basis of medical records and interviews.
  
  
  RESULTS
  Of the 1,180 identified COPD patients, 589 were included in this prospective study. In 22 patients (3.70%), the aortic diameter was ≥30 mm, representing an AAA prevalence of 6.72% among males aged >65 years. The risk of AAA increased with the following comorbidities/risk factors: male sex (odds ratio [OR] 2.98), coronary heart disease (OR 2.81), peripheral arterial occlusive disease (OR 2.47), hyperlipoproteinemia (OR 2.77), AAA in the family history (OR 3.95), and COPD stage I/II versus IV (OR 1.81).
  
  
  CONCLUSIONS
  The overall AAA prevalence of 3.7% in our group of COPD patients is similar to that of the general population aged >65 years. However, the frequency of AAA in male COPD patients aged >65 years is considerably higher (6.72%) and increased further still in those individuals with additional comorbidities/risk factors. Defining subgroups with a higher risk of AAA may increase the efficiency of screening.
authors.affiliation: Department for Vascular Medicine, Helios Klinikum Emil von Behring, Berlin, Germany.
authors.forename: Ingo H
authors.initials: IH
authors.lastname: Flessenkaemper
authors.affiliation: Department of Pneumology, Helios Klinikum Emil von Behring, Berlin, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Loddenkemper
authors.affiliation: Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Roll
authors.affiliation: Department for Vascular Medicine, Helios Klinikum Emil von Behring, Berlin, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Enke-Melzer
authors.affiliation: Department of Pneumology, Helios Klinikum Emil von Behring, Berlin, Germany.
authors.forename: Henrik
authors.initials: H
authors.lastname: Wurps
authors.affiliation: Department of Pneumology, Helios Klinikum Emil von Behring, Berlin, Germany.
authors.forename: Torsten T
authors.initials: TT
authors.lastname: Bauer
mesh_terms: D000367:Age Factors; D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods*; D016017:Odds Ratio; D018579:Patient Selection; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology*; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D014463:Ultrasonography
keywords: AAA; chronic obstructive pulmonary disease; epidemiology; inflammatory disease; risk factors; screening; tobacco abuse