title: Evaluation for abdominal aortic aneurysms is justified in patients with thoracic aortic aneurysms.
abstract: Aortic aneurysms are a significant cause of mortality, and the presence of multiple aneurysms may affect treatment plans. The purpose of this study was to determine the frequency of abdominal aortic aneurysms (AAAs) in patients with thoracic aortic aneurysms (TAAs) and to establish whether patient specific factors, such as gender and comorbidities, influenced the frequency of AAAs, thereby indicating if and when abdominal aortic evaluation is justified. Electronic medical records were reviewed from 1000 patients with a computed tomography (CT) angiogram of the chest and abdomen and a clinical diagnosis of TAA from Cardiac Surgery clinic between 2008 and 2013. 538 patients with history of aortic intervention, dissection, rupture or trauma were excluded. The frequency of AAAs among the 462 remaining patients was established, and statistical analysis was used to elucidate differences in frequency based on age, gender, comorbidities, and TAA location. Overall, 104 of 462 (22.5 %) patients with a TAA also had an AAA. There were significant differences in the frequency of AAA based on TAA location, age, and comorbidities. The following comorbidities showed positive associations with AAA using logistic regression analysis: age ≥65 (P < 0.0001; OR 30.1; CI 7.14-126.61), smoking history (P < 0.0001; OR 4.1; 2.35-7.30), and hypertension (P = 0.024; OR 2.1; CI 1.11-4.16). Aneurysms in the proximal/mid descending (P < 0.0001; OR 4.96; CI 2.32-10.61) and diaphragm level (P < 0.0001; OR 38.4; CI 14.71-100.15) of the aorta also showed a positive association with AAAs when adjusted for age and gender. AAA screening in patients with TAA is a reasonable, evidence-based option regardless of the TAA location, with the strongest support in patients >age 55, with systemic hypertension, a smoking history and/or a TAA in the descending thoracic aorta.
authors.affiliation: Medical School, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA.
authors.forename: Mariana R
authors.initials: MR
authors.lastname: DeFreitas
authors.affiliation: Department of Radiology, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109-5030, USA. lequint@umich.edu.|Department of Surgery, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA. lequint@umich.edu.
authors.forename: Leslie E
authors.initials: LE
authors.lastname: Quint
authors.affiliation: Michigan Institute for Clinical and Health Research, University of Michigan, 2800 Plymouth Road, Building 400, Ann Arbor, MI, 48109-2800, USA.
authors.forename: Kuanwong
authors.initials: K
authors.lastname: Watcharotone
authors.affiliation: Department of Biostatistics, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
authors.forename: Bin
authors.initials: B
authors.lastname: Nan
authors.affiliation: Frankel Cardiovascular Center, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Ranella
authors.affiliation: Frankel Cardiovascular Center, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA.
authors.forename: Joanna R
authors.initials: JR
authors.lastname: Hider
authors.affiliation: Department of Radiology, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109-5030, USA.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Liu
authors.affiliation: Department of Radiology, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109-5030, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Williams
authors.affiliation: Department of Surgery, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA.
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Eliason
authors.affiliation: Department of Cardiac Surgery, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA.
authors.forename: Himanshu J
authors.initials: HJ
authors.lastname: Patel
mesh_terms: D000367:Age Factors; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000453:epidemiology; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging* / Q000453:epidemiology; D001027:Aortography / Q000379:methods*; D016009:Chi-Square Distribution; D015897:Comorbidity; D000072226:Computed Tomography Angiography; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008824:Michigan / Q000453:epidemiology; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology
keywords: Aneurysm (abdominal aorta thoracic aorta); Aorta/aortic; Computed tomography; Imaging