Evaluation of risk factors and screening of abdominal aort anevrism in patients admitted to the emergency department with over the age of 65

Yıl 2014, Cilt: 5 Sayı: 17, 6 - 11, 03.03.2015

Gökhan Arslan Ali Karakuş Koca Çalışkan Mustafa Şahan Mehmet Duru Güven Kuvandık Yakup Erdoğan

https://doi.org/10.17944/mkutfd.95186

Cited By: 1

Öz

Background: A significant number of applications
to emergency services consists of elderly patients.
Elderly patients are at increased risk for abdominal
aortic aneurysms. Therefore, we measured the
diameter of the aorta in patients over the age of 65
and compared with the risk factors
Method: 150 patients, over 65 years old were
included in the study. The patients with trauma or
with any complaints or findings vascular disease,
have not been included in the study. Aortic
diameters were measured from separation zone of
the renal artery and the iliac bifurcation and the
remaining areas of the aorta were evaluated with
scanning. The data was evaluated with SPSS 20.0
statistical software and t-test, chi-square tests were
applied.
Results: 3 of the patients, 2 women and a man,
were identified AAA. Aortic diameters larger than
in the smokers compared to nonsmokers. (p<0,01)
Aortic diameters compared with other risk factors,
there were no statistically significant difference.
Conclusion: In our study, AAA has been found in
3 of 150 asymptomatic patients. Smoking and age
were found to be the most important risk factor for
AAA. Screening of AAA patients with bedside
ultrasound will allow early detection of AAA and
contribute to the reduction of mortality.

Anahtar Kelimeler

abdominal aortic aneurysm, scanning, bedside ultrasound

ACİL SERVİSE BAŞVURAN 65 YAŞ ÜSTÜ HASTALARDA ABDOMİNAL AORT ANEVRİZMA TARAMASI VE RİSK FAKTÖRLERİNİN DEĞERLENDİRİLMESİ

Öz

Amaç:Acil servislere başvuruların önemli bir
kısmını oluşturan yaşlı hastalarda abdominal aort
anevrizma riski fazladır. Bu sebeple 65 yaş ve üzeri
hastaların aort çapı ölçülerek risk faktörleri ile
birlikte değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem:65 yaş ve üzeri 150 hasta
çalışmaya dahil edildi. Travma ile acil servise
gelenler, vasküler olabilecek şikayet veya bulgu ile
gelenler çalışmaya dahil edilmedi. Hastaların renal
arter ayrım yerinden ve iliak bifurkasyo üzerinden
olmak üzere iki yerden aort çapları ölçülmüştür ve
aort boylu boyunca taranarak diğer arada kalan
alanlar da değerlendirildi. Veriler SPSS 20.0
istatistik programı ile değerlendirilmiş ve t-test, kikare
testleri uygulandı.

Bulgular:Abdominal aort anevrizması (AAA)
tesbit edilen 3 hastanın 2’si kadın cinsiyette idi.
Aort çapları sigara içen hastalarda içmeyenlere göre
daha geniştir(p<0,01). Diğer risk faktörleri ile aort
çaplarının kıyaslamasında istatistikî olarak anlamlı
fark saptanmadı.
Sonuç:Çalışmamızda 150 asemptomatik hastadan 3
kişide AAA tesbit edilmiştir. Sigara içimi ve yaşın
en önemli risk faktörü olduğu görülmüştür. AAA’lı
hastaların yatak başı USG ile taranması AAA için
erken teşhis olanağı sağlayacak ve mortalitenin
azaltılmasına katkıda bulunacaktır.

Anahtar Kelimeler

abdominal aort anevrizması, tarama, yatak başı ultrasonografi

Kaynakça

• Hollier LH, Stanson AW, Gloviczki P, Pairolero PC, Joyce JW, Bernatz PE. Arteriomegaly:
• classification and morbid implications of diffuse aneurysmal disease. Surgery 1983;93(5):700-8.
• Melton LJ, Bickerstaff LK, Hollier LH, Van Peenen HJ, Lie JT, Pairolero PC. Changing
• incidence of abdominal aortic aneurysms: a population-based study. American J of Epidemiology
• ;120(3):379-86.
• Guirguis EM, Barber GG. The natural history of abdominal aortic aneurysms. American J of
• Surg 1991 ;162(5):481-3.
• Noel AA, Gloviczki P, Cherry KJ, Bower TC, Panneton JM, Mozes GI. Ruptured abdominal
• aortic aneurysms: the excessive mortality rate of conventional repair. J of Vascular Surg
• ;34(1):41-6.
• Charboneau JW, Rumack CM, Wilson SR. Diagnostic Ultrasound. 3rd ed. Philadelphia,PA:
• Elsevier Mosby; 2005. p.1905–40.
• Kandiş H, Karakuş A, Katırcı Y, Karabolat S, Kara İH. Geriatrik Yaş Grubu ve Adli
• Travmalar. Turkish J of Geriatri 2011; 14(3): 193-8.
• Satar S, Sebe A, Avci A, Karakuş A, İçme F. Yaşlı hasta ve Acil Servis. Çukurova Üni Tıp
• Fak Derg 2004; 29(1): 43-50.
• Karakuş A, Yengil E, Arıca S, Zeren C, Çevik C, Erden ES, Çelik MM, Özer C. Huzurevi
• Sakinlerinin Acil Hastalıklarının Değerlendirilmesi. Turkish Family Phy 2012;3(3):16-22.
• Tintinalli J, Stapczynski J, Ma OJ, Cline D, Cydulka R, Meckler G. Tintinalli's Emergency
• Medicine: A Comprehensive Study Guide, Seventh Edition: Mcgraw-hill; 2010. p. 361-465.
• Wiesbauer F, Schlager O, Domanovits H, Wildner B, Maurer G, Muellner M, et al.
• Perioperative beta-blockers for preventing surgery-related mortality and morbidity: a systematic
• review and meta-analysis. Anesthesia and analgesia 2007; 104(1): 27-41.
• Force USPST. Screening for abdominal aortic aneurysm: recommendation statement. Ann of
• Int Med 2005;142(3):198-202.
• Wilmink TB, Quick CR, Hubbard CS, Day NE. The influence of screening on the incidence of
• ruptured abdominal aortic aneurysms. J of Vasc Surg 1999;30(6):203-8.
• Ashton HA, Buxton MJ, Day NE, Kim LG, Marteau TM, Scott RA. The Multicentre
• Aneurysm Screening Study (MASS) into the effect of abdominal aortic aneurysm screening on
• mortality in men: a randomised controlled trial. Lancet 2002;360(9345):1531-9.
• Fleming C, Whitlock E, Beil T, Lederle F. Primary Care Screening for Abdominal Aortic
• Aneurysm. Rockville; 2005. p.1-15.
• Simoni G, Pastorino C, Perrone R, Ardia A, Gianrossi R, Decian F, et al. Screening for
• abdominal aortic aneurysms and associated risk factors in a general population. European journal of
• vascular and endovascular surgery : the official journal of the Euro Soc for Vascular Surg
• ;10(2):207-10.
• Pleumeekers HJ, Hoes AW, Hofman A, van Urk H, van der Does E, Grobbee DE. Selecting
• subjects for ultrasonographic screening for aneurysms of the abdominal aorta: four different strategies.
• Int J of Epidemiology. 1999;28(4):682-6.
• Vardulaki KA, Walker NM, Day NE, Duffy SW, Ashton HA, Scott RA. Quantifying the risks
• of hypertension, age, sex and smoking in patients with abdominal aortic aneurysm. The British J of
• Surg 2000;87(2):195-200.
• Lederle FA, Nelson DB, Joseph AM. Smokers' relative risk for aortic aneurysm compared
• with other smoking-related diseases: a systematic review. J of Vascular Surg 2003;38(2):329-34.
• Wilmink TB, Quick CR, Day NE. The association between cigarette smoking and abdominal
• aortic aneurysms. J of Vascular Surg 1999;30(6):1099-105.
• Rodin MB, Daviglus ML, Wong GC, Liu K, Garside DB, Greenland P. Middle age
• cardiovascular risk factors and abdominal aortic aneurysm in older age. Hypertension. 2003;42(1):61-
• -
• Singh K, Bonaa KH, Jacobsen BK, Bjork L, Solberg S. Prevalence of and risk factors for
• abdominal aortic aneurysms in a population-based study : The Tromso Study. American J of
• Epidemiology 2001;154(3):236-44.
• Derubertis BG, Trocciola SM, Ryer EJ, Pieracci FM, McKinsey JF, Faries PL. Abdominal
• aortic aneurysm in women: prevalence, risk factors, and implications for screening. J of Vascular Surg
• ;46(4):630-5.