Justification of Screening for Peripheral Arterial Disease in the Elderly Population Through Clinical and Financial Cost-benefit Analysis.

Background: Peripheral arterial disease (PAD) is a chronic condition of reduced blood flow through the arteries. Early detection and prevention of PAD, especially in at-risk populations, is crucial to reducing morbidity and mortality.

Objective: The aim of the study was to examine the clinical feasibility of vascular ultrasound screening for early detection of PAD, as well as potential financial savings through preventive measures.

Methods: The study was conducted as a prospectively designed cross-sectional study with retrospective sample analysis, in which the sample consisted of 826 patients over 60 years of age, of both sexes, divided into two groups, conducted from January 2023 to May 2024.

Results: The study included 826 patients aged 60 and over, divided into two groups after ultrasound examination of the arteries (Group A with atherosclerosis /63.8%/; Group B - without atherosclerosis /36.2%/). The average age was 65.44±5.9 years, 60-65 years was 64.3%, and over 65 years was 35.7%. A statistically significant difference was recorded between the analyzed groups in terms of comorbidities and risk factors. We found that age, gender, hypertension, hyperlipidemia, diabetes, smoking and chronic obstructive disease have a significant relationship with the degree of atherosclerosis. Multivariate analysis showed that the age of the subjects, hyperlipidemia, hypertension and smoking are significant predictors of atherosclerosis. The prevalence for hemodynamically significant stenosis of ACI/ACC was 5.0%, for peripheral arteries 4.2%, the prevalence of aneurysm abdominal aorta (>3 cm) was 2.3%, and 0.5% for diameter >5 cm.

Conclusion: The results show the high efficiency of ultrasound diagnostics in identifying asymptomatic patients with advanced atherosclerosis, emphasizing the need for better organization of preventive programs, which could lead to potential savings in healthcare costs through earlier detection and treatment.