Ultrasonographic Measurements of Abdominal Aortic Diameter in Elderly Patients

ABSTRACT

BACKGROUND: Researchers have reported that the prevalence of abdominal aortic aneurysm(AAA) is 1~4% in the entire population and 4~9% in the population older than 65 years. 40 to 50% of AAA patients die before arrival at a hospital; and mortality from a ruptured AAA is greater than 90%. Moreover, diagnosis is frequently delayed because the majority of patients are asymptomatic. Even if AAA is quickly diagnosed(ruptured or symptomatic) and operated on, survival rate is less than 50%. Recently, trials have been done to detect asymptomatic AAA by ultrasonography in the elderly population with a subsequent increase in the number of surgeries of asymptomatic AAA. Method: We measured the diameter of the abdominal aorta in all patients aged 65 years and older seen in the emergency room at Chuncheon Sacred Heart Hospital, Hallym University. We investigated the correlations between risk factors and prevalence of AAA and the diameter of the abdominal aorta. We also screened for age, gender, and history of smoking, hypertension, coronary heart disease, and CVA. RESULTS: 444 cases were enrolled in this study with 185 being male(41.7%) and 259 female(58.3%). Mean age was 73.91+/-7.02 years. Mean maximum diameter of the abdominal aorta was 2.08+/-0.37cm. Comparing maximum diameters, men averaged 2.17+/-0.37cm and women 2.01+/-0.35 cm (p<0.001); smokers 2.16+/-0.39cm and nonsmokers 2.05+/-0.35cm(p=0.007); hypertension history 2.10+/-0.42 cm and no hypertension history 2.06+/-0.33cm(p=0.246); coronary heart disease history 2.35+/-0.84cm and no coronary heart disease 2.07+/-0.35 cm(p=0.01); and CVA history 2.08+/-0.37 cm and no CVA history 2.08+/-0.37cm(p=0.997). CONCLUSION: There were notable differences in the maximum abdominal aortic diameter with gender and histories of smoking, hypertension, and coronary heart disease. Ultrasound screening of AAA should be strongly recommended in male smokers 65 years and older with a history of coronary heart disease. Overall, ultrasound screening of AAA for elderly patients should be carefully considered.