|
E-mail this page to a friend!
Senior Citizen Health & Medicine
Senior Men Dramatically Cut Death Risk from Ruptured
Aneurysm with Screening
Checking for abdominal aortic aneurysms cuts deaths
in half for men 65 - 79, does not help women
April 18, 2007 - Regular ultrasound screening for
abdominal aortic aneurysms can sharply reduce the likelihood of dying
from a ruptured aneurysm among men age 65 and older, according to a new
review of recent studies. Screening helped cut the odds of death nearly
in half for men ages 65 to 79 but did not reduce deaths among women.
However, men who received screening were also twice
as likely to undergo surgery for the condition, a procedure that carries
its own risk of death, says Dr. Paul Cosford of the East of England
Strategic Health Authority.
The four studies included 127,891 men and 9,342
women.
The review by Cosford and Dr. Gillian Leng of the
National Institute for Clinical Excellence in England appears in the
latest issue of The Cochrane Library, a publication of The Cochrane
Collaboration, an international organization that evaluates medical
research. Systematic reviews draw evidence-based conclusions about
medical practice after considering both the content and quality of
existing medical trials on a topic.
Aneurysms are places in the aorta that have become
wider as the large blood vessel travels through the abdomen. As the
artery balloons out at a certain spot, the aorta walls become weaker,
increasing the chance that it will burst. A burst aorta is often fatal
almost 80 percent of people who reach a hospital after the aorta
ruptures will die.
Screening could help save many of these lives,
since surgeons can repair an aneurysm before it bursts, usually before
it grows larger than two inches in diameter.
However, screening for these aneurysms is somewhat
controversial, since the balance between risk of rupture and risk of
elective surgical repair
is difficult to judge for people who are
healthy, Cosford said.
Patients may therefore be asked to undergo this
risk to repair a large aneurysm which may not kill them, he said,
adding that some people may also become significantly anxious about
smaller aneurysms that do not need surgery.
In 2007, after several high-profile news accounts
about the condition, Medicare began offering abdominal aortic aneurysm
screening for those at high risk for the condition, including men over
65 who have smoked and women with a family history of aneurysms.
If the initial screening turns up an aneurysm, the
reviewers say that current practice is to do a repeat ultrasound every
three to six months for aneurysms smaller than 5 centimeters (2 inches).
Although evidence suggests that the risk of
abdominal aortic aneurysm is higher in men than women, Cosford says
researchers need to find out more about the benefits and harms of
screening in women.
Dr. Angela Vouyouka, a vascular surgeon at New York
Presbyterian Hospital, said aneurysms may be a larger problem in women
than most researchers think. Womens aneurysms and aortas are
smaller than in men, making it more difficult to tell when they have
reached a dangerous size, she said.
Older women may also miss out on important
screenings for social reasons, she suggested. At this point of their
life women are very likely to either take care of an older and sicker
spouse or live alone
they are not seeking medical help or keeping
their medical appointments as vigorously as their male counterparts do.
The Cochrane Collaboration is an international
nonprofit, independent organization that produces and disseminates
systematic reviews of health care interventions and promotes the search
for evidence in the form of clinical trials and other studies of
interventions. Visit
http://www.cochrane.org for
more information.
Source: Cosford PA, Leng GC. Screening for abdominal aortic
aneurysm (Review). Cochrane Database of Systematic Reviews 2007, Issue
2.
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
