腹主动脉瘤超声筛查的适宜性:遵循指南和回顾既往影像学的潜在成本节约。

Matthew Murray, Andreu F Costa
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引用次数: 3

摘要

目的:评估腹主动脉瘤(AAA)超声筛查(US)的适宜性,并通过遵循指南和回顾既往影像学来节省潜在的费用。方法:回顾2019年1月1日至4月30日在新斯科舍省进行的主动脉US筛查。结果:369例扩张性主动脉17例(4.6%),369例aaa 18例(4.9%)。潜在避免检查的次数、错过扩张主动脉的次数、错过AAAs的次数和节省的费用分别如下:CTFPHC为369、8、7和20501.70加元,分别为222 (60.2%);CSVS, 369、4、2中的117(31.7%),加币$10 804.95。将CSVS指南与5年内的既往影像学检查相结合,可以最大限度地节省成本并减少阳性结果的遗漏;这将避免369次检查中的189次(51.2%),在4个月内节省17 454.15加元,仅遗漏2例aaa和2例扩张主动脉。结论:通过遵守CSVS指南并回顾5年内的影像学检查,可以安全地避免超过一半的主动脉US筛查试验。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Appropriateness of Abdominal Aortic Aneurysm Screening With Ultrasound: Potential Cost Savings With Guideline Adherence and Review of Prior Imaging.

Objective: To assess the appropriateness of abdominal aortic aneurysm (AAA) screening with ultrasound (US) and potential cost savings by adhering to guidelines and reviewing prior imaging.

Methods: Screening aortic US performed in Nova Scotia from January 1 to April 30, 2019, were reviewed. Patient sex, age, risk factors, and study result (negative, <2.5 cm; ectatic, 2.5-2.9 cm; positive for AAA, ≥3 cm) were recorded. Previous imaging tests were reviewed for the presence/absence of aortic ectasia or aneurysm. Appropriateness was based on the Canadian Task Force on Preventive Health Care (CTFPHC) and the Canadian Society of Vascular Surgery (CSVS) guidelines. The number of potentially averted US, subsequent missed positive findings, and cost savings (over the 4-month period) were calculated according to: 1) each guideline; and 2) each guideline combined with review of imaging done 0 to 5 years and 0 to 10 years previously.

Results: There were 17 (4.6%) of 369 ectatic aortas and 18 (4.9%) of 369 AAAs. The number of potentially averted examinations, missed ectatic aortas, missed AAAs, and cost savings were as follows, respectively: CTFPHC, 222 (60.2%) of 369, 8, 7, and CAD$20 501.70; CSVS, 117 (31.7%) of 369, 4, 2, and CAD$10 804.95. The model that would yield the greatest cost savings and fewest missed positive findings was the combination of CSVS guidelines with review of prior imaging within 5 years; this would avert 189 (51.2%) of 369 examinations, save CAD$17 454.15 over 4 months, and miss only 2 AAAs and 2 ectatic aortas.

Conclusion: Over half of aortic US screening tests can be safely averted by adhering to CSVS guidelines and reviewing imaging performed within 5 years.

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