Abdominal aortic aneurysms are less common in women than men. Chabok et al identified risk factors which can help to select a woman who should be screened for aneurysm. THe authors are from Guy’s and St. Thomas’ Hospital in London, Wessex Scientific Medical Ultrasound Consultancy in Southampton and University of Nicosia in Cyprus.
Patient selection: adult woman
Outcome: abdominal aortic aneurysm
The presence of aneurysm is very low in women less than 60 years of age, so screening is usually not performed.
Risk factors for abdominal aortic aneurysm:
(1) age in years
(2) history of stroke and/or transient ischemic attack (TIA)
(3) hypertension
(4) smoking history in 10 pack years
(5) atrial fibrillation
(6) ankle to brachial pressure index (ABPI)
(7) stenosis of internal carotid arteries in percent
|
Parameter |
Finding |
Points |
|
age |
< 76 years of age |
0 |
|
|
>= 76 years of age |
1 |
|
history of stroke and/or TIA |
no |
0 |
|
|
yes |
1 |
|
hypertension |
no |
0 |
|
|
yes |
1 |
|
smoking history |
none or < 10 pack years |
0 |
|
|
>= 10 pack years |
1 |
|
atrial fibrillation |
absent |
0 |
|
|
present |
1 |
|
ABPI |
>= 0.9 in both legs |
0 |
|
|
< 0.9 in one or both legs |
1 |
|
stenosis of internal carotid artery |
< 50% in both arteries |
0 |
|
|
>= 50% in one or both |
1 |
where:
• A family history of abdominal aortic aneurysm had an odds ratio of 1.93 and p value of 0.043 but was not included in the final list.
total number of risk factors =
= SUM(points for each parameter)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 7
Using a multivariate prediction model (beta-coefficients and intercept not provided) the area under the ROC curve was 0.78.
Specialty: Cardiology
