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首页> 外文期刊>Clinical and investigative medicine: Medecine clinique et experimentale >The detection and management of abdominal aortic aneurysm: a cost-effectiveness analysis.
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The detection and management of abdominal aortic aneurysm: a cost-effectiveness analysis.

机译：腹主动脉瘤的检测和管理：成本效益分析。

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BACKGROUND: Abdominal aortic aneurysm (AAA) is an important cause of death in Canada, and about 80% of the deaths are due to ruptured aneurysm. METHOD: To determine the most cost-effective way of controlling AAA in terms of early detection and clinical management, a cohort analysis was undertaken beginning at age 50 years, using a multistate life-table model with parameters derived from published articles. The model was used to determine (a) the optimum size for elective surgery and (b) the optimum rate of detection of intact AAA. Cost per quality-adjusted life-year (QALY) was used to measure outcome. RESULTS: The most cost-effective diameter for repair of an intact AAA increases with age between the limits of 55 and 70 mm. The predominant size for repair is 60 mm. The most cost-effective rate at which latent AAA should be detected is 20% per year, corresponding to a screening interval of 5 years. Selective screening by sex or smoking status, or both, does not improve cost-effectiveness. CONCLUSIONS: Primary care patients aged 50 years and over should be offered abdominal ultrasonography every 5 years. Those with AAA should be kept under surveillance and offered elective surgery when the aneurysm reaches 60 mm in diameter.
机译：背景：腹主动脉瘤（AAA）是加拿大的重要死因，约80％的死亡归因于动脉瘤破裂。方法：为了确定在早期发现和临床管理方面控制AAA的最经济有效的方法，从50岁开始，使用多状态寿命表模型和从已发表文章中得出的参数进行队列分析。该模型用于确定（a）选择性手术的最佳尺寸和（b）完整AAA的最佳检测率。每质量调整生命年的成本（QALY）用于衡量结果。结果：修复完整AAA的最具成本效益的直径随年龄在55到70 mm的范围内而增加。维修的主要尺寸为60毫米。潜在AAA的最高成本效益率是每年20％，相当于5年的筛选间隔。按性别或吸烟状况（或两者兼有）进行选择性筛查不会提高成本效益。结论：50岁及50岁以上的初级保健患者应每5年接受一次腹部超声检查。当动脉瘤直径达到60 mm时，应对具有AAA的患者进行监视并进行择期手术。

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