Article type
Year
Abstract
Introduction/Objective: the mortality rate associated with rupture of abdominal aortic aneurysm (AAA) is very high. Optimal management for patients with AAA involves early identification and elective surgery. Data on risk factors for AAA might be useful for a selective screening among high-risk populations. We performed a systematic review of associated factors with AAA.
Methods: original studies were identified by searching Medline and Embase databases (1985-1997) in four languages (English, German, French and Italian) with a very sensitive choice of key words. Two independent assessors (good agreement, kappa=0.58) performed a first selection of the retrieved articles (n=2238) on the basis of title and abstract. Disagreement was resolved by discussion. The selected articles (n=170) were analyzed with an extraction table according to quality criteria including a precise definition of AAA, associated factors and study population, as well as sample size. Only cross-sectional studies were included and the results are expressed in odds ratio (OR). Since the definition of associated factors might vary across studies, we only pooled the results of studies in which the definition of associated factor was similar. We used the EasyMA software to calculate the OR (fixed model) over studies.
Results: 19 primary studies fulfilled the quality/inclusion criteria. The OR (95% CI) for male gender and age over 69 are 4.0 (3.5 - 4.5) and 1.7 (1.5 -1.9). Graphically, the following situations seem clearly associated with AAA: smoking, peripheral arterial disease, myocardial infarction, cerebral vascular disease, chronic obstructive pulmonary disease. Hypertension is only slightly associated with AAA and diabetes is probably not associated with AAA.
Discussion: this systematic review synthesizes the current knowledge of AAA epidemiology and provides an estimation of associated factors. The most important associated factor with AAA is male gender, while hypertension is only a minor associated factor.
Methods: original studies were identified by searching Medline and Embase databases (1985-1997) in four languages (English, German, French and Italian) with a very sensitive choice of key words. Two independent assessors (good agreement, kappa=0.58) performed a first selection of the retrieved articles (n=2238) on the basis of title and abstract. Disagreement was resolved by discussion. The selected articles (n=170) were analyzed with an extraction table according to quality criteria including a precise definition of AAA, associated factors and study population, as well as sample size. Only cross-sectional studies were included and the results are expressed in odds ratio (OR). Since the definition of associated factors might vary across studies, we only pooled the results of studies in which the definition of associated factor was similar. We used the EasyMA software to calculate the OR (fixed model) over studies.
Results: 19 primary studies fulfilled the quality/inclusion criteria. The OR (95% CI) for male gender and age over 69 are 4.0 (3.5 - 4.5) and 1.7 (1.5 -1.9). Graphically, the following situations seem clearly associated with AAA: smoking, peripheral arterial disease, myocardial infarction, cerebral vascular disease, chronic obstructive pulmonary disease. Hypertension is only slightly associated with AAA and diabetes is probably not associated with AAA.
Discussion: this systematic review synthesizes the current knowledge of AAA epidemiology and provides an estimation of associated factors. The most important associated factor with AAA is male gender, while hypertension is only a minor associated factor.