Cribado ecográfico del aneurisma de aorta abdominal (AAA) en atención primaria en una población rural

Abstract

Objective

To assess the feasibility of implementing ultrasound screening for abdominal aortic aneurysm (AAA) in primary care by examining the prevalence of AAA and associated risk factors in northern Lleida, where no prior data exist and cases are detected opportunistically.

Design

Cross-sectional retrospective prevalence study derived from a pilot implementation of ultrasound AAA screening as a routine complementary test in six rural primary care centres over a 12-month period (March 2022 – March 2023).

Setting

Northern area of the province of Lleida, specifically the regions of Alt Urgell, Pallars Sobirà, Pallars Jussà and Alta Ribagorça.

Participants

All individuals aged 65 years were systematically invited by telephone, excluding those with a prior diagnosis of AAA.

Main measurements

Twelve general practitioners and six nurses performed abdominal ultrasounds to measure the external diameter of the infrarenal aorta. Cardiovascular risk factors were recorded. Prevalence included newly detected, known and estimated cases among non-participants.

Results

A total of 377 individuals participated (186 women and 191 men) out of 576 candidates, representing a participation rate of 65.5%. Six abdominal aortic aneurysms (AAAs) were diagnosed, all in men (3.14%; 95% CI: 0.6%–5.5%), with a statistically significant difference compared to women (0%; p = 0.030). The mean aortic diameter was 1.92 cm in men and 1.67 cm in women. The estimated population prevalence of AAA was 1.7% (10/576; 95% CI: 0.8%–3.2%).

Conclusions

Ultrasound screening for AAA performed by primary care professionals is feasible, reliable and yields results comparable to those of other studies. Its implementation requires standardised methodology and proper definition of at-risk groups.