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JAMA Clinical Guidelines Synopsis
March 17, 2015

Screening for Abdominal Aortic Aneurysm

Author Affiliations
  • 1University of Chicago, Chicago, Illinois
JAMA. 2015;313(11):1156-1157. doi:10.1001/jama.2015.0996

Abdominal aortic aneurysms are defined by an aortic anteroposterior diameter of 3 cm or more.1 Population-based ultrasound screening and autopsy studies suggest a prevalence of any AAA in adults older than 50 years of 4% to 8% in men and 1% to 1.3% in women.2 Risk factors for AAA include age, male sex, having ever smoked, and family history of AAA. Abdominal aortic aneurysms often remain asymptomatic until rupture, a complication associated with mortality rates as high as 75% to 90%.2 Risk of rupture varies with aneurysm diameter (annual risk of 0% in aneurysms 3-3.9 cm, 1% in aneurysms 4-4.9 cm, and 11% in aneurysms 5-5.99 cm).3 Outcomes for emergency surgical intervention are also poor, with combined in-hospital and 30-day mortality rates of 40%.2 Ultrasonography is a safe and cost-effective screening tool that is highly sensitive (94%-100%) and specific (98%-100%) for detecting AAAs.1,2