Vascular Research Unit, Viborg Hospital, Viborg, Denmark.
Br J Surg. 2011 May;98(5):619-22. doi: 10.1002/bjs.7464. Epub 2011 Mar 4.
The aim of this study was to compare the mortality rate within 30 days of elective surgery for abdominal aortic aneurysm (AAA) in men randomized to an invitation for ultrasound screening with that of men in the control group, whose aneurysms were detected incidentally.
Relevant reports from randomized trials of screening were identified through a systematic search of MEDLINE. Four relevant trials were identified, and supplemented with data from the Viborg Vascular screening trial. Data were updated in two studies. Meta-analysis was undertaken with effects calculated as a fixed odds ratio (OR) with 95 per cent confidence interval. Heterogeneity between the studies was assessed by the χ(2) test.
There were 25 deaths (2·9 per cent) following elective surgery in 858 men invited for screening compared with 21 (5·5 per cent) of 383 in the control group (OR 0·49, 0·27 to 0·88). There were 18 deaths (2·4 per cent) following elective surgery for 747 screen-detected AAAs compared with 28 (6·1 per cent) following elective repair of 459 incidentally detected aneurysms (OR 0·37, 0·20 to 0·68).
The offer of screening identifies men whose early survival following elective AAA repair is better than that of men with an AAA detected incidentally.
本研究旨在比较接受选择性腹主动脉瘤（AAA）手术的男性中，随机接受超声筛查邀请的男性与意外发现动脉瘤的对照组男性在 30 天内的死亡率。
通过系统检索 MEDLINE 确定了筛查随机试验的相关报告。确定了四项相关试验，并补充了 Viborg 血管筛查试验的数据。两项研究的数据都进行了更新。采用固定比值比（OR）及其 95%置信区间进行荟萃分析。通过 χ(2)检验评估研究之间的异质性。
在 858 名接受筛查邀请的男性中，有 25 人（2.9%）在选择性手术治疗后死亡，而在 383 名对照组男性中，有 21 人（5.5%）在选择性手术治疗后死亡（OR 0.49，0.27 至 0.88）。在 747 例经筛查发现的 AAA 中，有 18 人（2.4%）在选择性手术治疗后死亡，而在 459 例意外发现的动脉瘤中，有 28 人（6.1%）在选择性修复后死亡（OR 0.37，0.20 至 0.68）。
筛查的提供可以确定那些在接受选择性 AAA 修复后早期生存情况更好的男性，而这些男性的 AAA 是通过筛查发现的，而非意外发现的。
