Lindholt J S, Juul S, Fasting H, Henneberg E W
Department of Vascular Surgery, Viborg Hospital, Viborg, Denmark.
Eur J Vasc Endovasc Surg. 2002 Jan;23(1):55-60. doi: 10.1053/ejvs.2001.1534.
to analyse the hospital costs and benefits of screening older males for abdominal aortic aneurysm (AAA).
in 1994 a hospital-based screening trial of 12 658 65-73-year-old males was started. AAA >5 cm were referred for surgery. The remaining AAA were offered annual scans. Those with aortic ectasia were rescreened at 5 yearly intervals. AAA-operations and hospital AAA-related deaths were researched. The costs of screening, surveillance, and treatment were also registered.
the attendance rate was 76%; of whom 191 (4.0%) had AAA. Mean observation time was 5.13 years. Sixty in the screened and 41 in the control group were operated (p=0.06), of which 7 and 27 respectively were operated as an emergency (p<0.001), and 6 and 19 respectively died due to AAA (p=0.009). The costs per scan were 83.50 DKK, 81 400 DKK per emergency operation (71 485 DKK after screening), and 117 000 DKK per emergency operation. The cost per prevented hospital death was 67 855 DKK, equivalent to approximately life year saved approx. 7540 DKK (GBP1=12 DKK).
screening appears to reduce hospital AAA mortality and to be cost-effective.
分析对老年男性进行腹主动脉瘤（AAA）筛查的医院成本和效益。
1994年启动了一项基于医院的针对12658名65 - 73岁男性的筛查试验。直径大于5厘米的腹主动脉瘤患者被转诊接受手术。其余腹主动脉瘤患者每年接受扫描。主动脉扩张患者每5年重新筛查一次。对腹主动脉瘤手术和医院内与腹主动脉瘤相关的死亡情况进行研究。同时记录筛查、监测和治疗的费用。
参与率为76%；其中191人（4.0%）患有腹主动脉瘤。平均观察时间为5.13年。筛查组60人、对照组41人接受了手术（p = 0.06），其中分别有7人和27人作为急诊接受手术（p < 0.001），分别有6人和19人因腹主动脉瘤死亡（p = 0.009）。每次扫描费用为83.50丹麦克朗，每次急诊手术费用为81400丹麦克朗（筛查后为71485丹麦克朗），每次择期手术费用为117000丹麦克朗。预防每例医院死亡的成本为67855丹麦克朗，相当于每挽救一个生命年约7540丹麦克朗（1英镑 = 12丹麦克朗）。
筛查似乎可降低医院内腹主动脉瘤死亡率，且具有成本效益。
