• Medicina clinica · Nov 2013

    Clinical Trial

    [Feasibility of hand-held-ultrasonography in the screening of abdominal aortic aneurysms and abdominal aortic atherosclerosis].

    • Antoni Sisó-Almirall, Rosa Gilabert Solé, Concepció Bru Saumell, Belchin Kostov, Minerva Mas Heredia, Luis González-de Paz, Laura Sebastián Montal, and Benavent Àreu Jaume J.
    • Centro de Salud Les Corts, Consorci d'Atenció Primària de Salut l'Eixample (CAPSE), Grupo Transversal de Investigación en Atención Primaria, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España. Electronic address: asiso@clinic.ub.es.
    • Med Clin (Barc). 2013 Nov 16; 141 (10): 417-22.

    Background And ObjectiveTo determine the prevalence of abdominal aortic aneurysm (AAA) and abdominal aortic atheromatosis (AA-At) using a hand-held ultrasound by a general practitioner in the public Primary Health Care system.Patients And MethodPilot study that prospectively studied a cohort of men over 50 years with cardiovascular risk factors: active smokers, former smokers, or hypertensive patients, attended in primary health care center. The general practitioner completed an ultrasonography training in an Ultrasound Unit under supervision of experienced radiologists using an standard ultrasound equipment and hand-held ultrasound (VScan(®), General Electric, USA). One hundred and six patients participated in the study and all imaging data recorded were blindly evaluated by a radiologist in order to establish the concordance in the interpretation of images between general practitioner and radiologist. The kappa index was calculated to study the agreement on the presence or absence of AAA and AA-At.ResultsWe observed a prevalence of 5.88% of AAA. Kappa index for concordance in AAA diagnosis was absolute (κ = 1.0), with a sensitivity and specificity of 100%. Otherwise, the general practitioner identified 59 patients (58.4%) with AA-At, while radiologist identified 39 (38.6%) in the image review, with moderate concordance (κ = .435), sensitivity 89.74% and specificity 57.14%. Hypercholesterolemia (odds ratio [OR] 2.61; 95% confidence interval [95% CI] 0.92-7.39) and diabetes mellitus (OR 3.35; 95%CI 0.89-12.55) were independent risk factors for AA-At development in logistic regression.ConclusionsAfter an adequate training in ultrasonography, hand-held ultrasound is a useful tool for AAA screening in Primary Care. Its simplicity, security, validity, cost-effectiveness and acceptance by the general population, makes it a feasible tool for cardiovascular risk assessment.Copyright © 2012 Elsevier España, S.L. All rights reserved.

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