title: Outcome in Men with a Screen-detected Abdominal Aortic Aneurysm Who are not Fit for Intervention.
abstract: OBJECTIVE
  Abdominal aortic aneurysm (AAA) screening in Gloucestershire has been ongoing for 25 years. The aim of this study was to review the outcome of a cohort of men with a large (> 5.4 cm) screen-detected AAA who did not have early intervention for their AAA.
  
  
  METHODS
  A prospectively maintained database was interrogated for a 10-year interval from 2001 to 2011. Men who did not have their large AAA repaired within 3 months of the diagnosis were identified. The reasons for initial nonintervention and subsequent outcomes were identified from a combination of hospital case notes and general practitioner records.
  
  
  RESULTS
  Of 334 men referred, 59 (median age 71 years, range 62-83 years) did not have intervention within 3 months (initial nonintervention rate 17.6%). The reasons included placed back on surveillance after assessment (n = 34); immediately discharged (n = 12); required further investigations (n = 5); died before complete assessment (n = 3); and incomplete follow-up (n = 5). Sixteen men had delayed AAA repair with no perioperative mortality. Overall mortality in the study was 14/34 (nine from ruptured AAA, the rest from medical conditions). Two further men survived repair of a ruptured AAA. The overall rate of ruptured AAA was 11/59 (18.6%).
  
  
  CONCLUSIONS
  Information from studies such as these can be used to help plan treatment of men with a large AAA and to compare performance of vascular units.
authors.affiliation: Department of Vascular Surgery, Cheltenham General Hospital, Cheltenham GL1 3NN, UK.
authors.forename: J
authors.initials: J
authors.lastname: Lim
authors.affiliation: Department of Vascular Surgery, Cheltenham General Hospital, Cheltenham GL1 3NN, UK.
authors.forename: J
authors.initials: J
authors.lastname: Wolff
authors.affiliation: Department of Vascular Surgery, Cheltenham General Hospital, Cheltenham GL1 3NN, UK.
authors.forename: C D
authors.initials: CD
authors.lastname: Rodd
authors.affiliation: Department of Vascular Surgery, Cheltenham General Hospital, Cheltenham GL1 3NN, UK.
authors.forename: D G
authors.initials: DG
authors.lastname: Cooper
authors.affiliation: Department of Vascular Surgery, Cheltenham General Hospital, Cheltenham GL1 3NN, UK. Electronic address: jonothan.earnshaw@glos.nhs.uk.
authors.forename: J J
authors.initials: JJ
authors.lastname: Earnshaw
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D018450:Disease Progression; D004739:England; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012017:Referral and Consultation; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D061665:Time-to-Treatment; D014463:Ultrasonography; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D057832:Watchful Waiting
keywords: Aortic aneurysm; Aortic aneurysm screening; Outcomes research