Prediction model of isolated iliac and abdominal aneurysms.
Age Factors
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal
/ diagnostic imaging
Body Mass Index
Diabetes Mellitus
/ epidemiology
Dyslipidemias
/ epidemiology
Female
Heart Diseases
/ epidemiology
Humans
Hypertension
/ epidemiology
Iliac Aneurysm
/ diagnostic imaging
Incidence
Logistic Models
Male
Mass Screening
Middle Aged
Risk Assessment
Ultrasonography
abdominal aortic aneurysm
cardiovascular risk factors
isolated iliac aneurysm
logistic regression prediction
screening
Journal
European journal of clinical investigation
ISSN: 1365-2362
Titre abrégé: Eur J Clin Invest
Pays: England
ID NLM: 0245331
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
revised:
03
02
2021
received:
21
10
2020
accepted:
03
02
2021
pubmed:
12
2
2021
medline:
21
12
2021
entrez:
11
2
2021
Statut:
ppublish
Résumé
We analyse the cardiovascular risk factors in patients undergoing screening for Isolated Iliac Aneurysm (IIA) and Abdominal Aortic Aneurysm (AAA) and propose a logistic regression model to indicate patients at risk of IIA and/or AAA. A screening programme was carried out to identify the presence of aneurysm based on Duplex scan examination. Cardiovascular risk factors information was collected from each subject. A descriptive analysis for the incidence of IIA and AAA stratified by age and sex was carried out to evaluate factors incidence. A logistic regression model was developed to predict the probability of developing an aneurysm based on the observed risk factor levels. A threshold probability of aneurysm risk for a datum patient was also identified to effectively direct screening protocols to patients most at risk. A cohort of 10 842 patients was evaluated: 1.52% affected by IIA, 2.69% by AAA and 3.90% by at least one. Risk factors analysis showed that: IIA was correlated with cardiological status, diabetes, cardiovascular disease family history, and dyslipidaemia; AAA was correlated with cardiological status, body mass index, hypertension, and dyslipidaemia; diabetes and dyslipidaemia were the most relevant factors with at least one aneurysm. The prediction tool based on the logistic regression and the threshold probability predict the presence of IIA and AAA in 69.7% and 83.8% of cases, under k-fold cross-validation. The proposed regression model can represent a valid aid to predict IIA and AAA presence and to select patients to be screened.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13517Informations de copyright
© 2021 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.
Références
Nachbur BH, Inderbitzi RGC, Bär W. Isolated iliac aneurysms. Eur J Vasc Surg. 1991;5(4):375-381.
Chaer RA, Barbato JE, Lin SC, Zenati M, Kent KC, McKinsey JF. Isolated iliac artery aneurysms: a contemporary comparison of endovascular and open repair. J Vasc Surg. 2008;47(4):708-713.
Krupski WC, Selzman CH, Floridia R, Strecker PK, Nehler MR, Whitehill TA. Contemporary management of isolated iliac aneurysms. J Vasc Surg. 1998;28:1-11.
Parker LP, Powell JT, Kelsey LJ, et al. Morphology and hemodynamics in isolated common iliac artery aneurysms impacts proximal aortic remodeling. Arterioscler Thromb Vasc Biol. 2019;39(6):1125-1136.
US Preventive Services Task Force, Draft recommendation statement: abdominal aortic aneurysm: screening (2019). www.uspreventiveservicestaskforce.org/Page/Document/draftrecommendation-statement/abdominal-aortic-aneurysm-screening. Accessed December 10, 2019.
Carnevale ML, Koleilat I, Lipsitz EC, Friedmann P, Indes JE. Extended screening guidelines for the diagnosis of abdominal aortic aneurysm. J Vasc Surg. 2020.72(6):1917-1926.
Palombo D, Lucertini G, Pane B, Mazzei R, Spinella G, Brasesco PC. District-based abdominal aortic aneurysm screening in population aged 65 years and older. J Cardiovasc Surg (Torino). 2010;51(6):777.
Editor's Choice e European Society for Vascular Surgery (ESVS). 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms.
Dolgin M, Association NYH, Fox AC, Gorlin R, Levin RI, New York Heart Association. Criteria Committee. Nomenclature and criteria for diagnosis of diseases of the heart and great vessels; 1994.
O'Donnell TF, Landon BE, Schermerhorn ML. The case for expanding abdominal aortic aneurysm screening. J Vasc Surg. 2020;71(5):1809-1812.
Chaikof EL, Dalman RL, Eskandari MK, et al. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. J Vasc Surg. 2018;67(1):2-77.
Cosford, PA, Leng, GC, Thomas, J. Screening for abdominal aortic aneurysm. Cochrane Database Syst Rev. 2007. http://dx.doi.org/10.1002/14651858.cd002945.pub2.
Brunkwall J, Hauksson H, Bengtsson H, Bergqvist D, Takolander R, Bergentz SE. Solitary aneurysms of the iliac arterial system: an estimate of their frequency of occurrence. J Vasc Surg. 1989;10(4):381-384.
US Preventive Services Task Force. Screening for abdominal aortic aneurysm: Us preventive services task force recommendation statement. JAMA. 2019;322(22):2211-2218.
Kent KC, Zwolak RM, Egorova NN, et al. Analysis of risk factors for abdominal aortic aneurysm in a cohort of more than 3 million individuals. J Vasc Surg. 2010;52(3):539-548.
Durieux R, Van Damme H, Labropoulos N, et al. High prevalence of abdominal aortic aneurysm in patients with three-vessel coronary artery disease. Eur J Vasc Endovasc Surg. 2014;47(3):273-278.
Raffort J, Lareyre F, Clément M, Hassen-Khodja R, Chinetti G, Mallat Z. Diabetes and aortic aneurysm: current state of the art. Cardiovasc Res. 2018;114(13):1702-1713.
Giardina S, Pane B, Spinella G, et al. An economic evaluation of an abdominal aortic aneurysm screening program in Italy. J Vasc Surg. 2011;54(4):938-946.
Arnaoutakis, D. J., Upchurch G. R.. Abdominal Aortic Aneurysm Screening Is Safe yet Lacks Effectiveness. Circulation. 2019;139(11):1381-1383. http://dx.doi.org/10.1161/circulationaha.118.038809.