This article is part of the supplement: Selected articles from the XXV National Congress of the Italian Society of Geriatric Surgery
Abdominal aortic aneurysm in patients affected by intermittent claudication: prevalence and clinical predictors
1 Department of Clinical Medicine and Cardiovascular and Immunological Sciences, “Federico II” University”, via Pansini 5, 80131, Naples, Italy
2 Department of Biology and Cellular and Molecular Pathology, Federico II University, via Pansini 5, 80131, Naples, Italy
3 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, “Federico II” University”, via Pansini 5, 80131, Naples, Italy
BMC Surgery 2012, 12(Suppl 1):S17 doi:10.1186/1471-2482-12-S1-S17Published: 15 November 2012
Abdominal aortic aneurysm (AAA) is a frequent cause of death among elderly. Patients affected by lower extremity peripheral arterial disease (LE-PAD) seem to be particularly at high risk for AAA. We aimed this study at assessing the prevalence and the clinical predictors of the presence of AAA in a homogeneous cohort of LE-PAD patients affected by intermittent claudication.
We performed an abdominal ultrasound in 213 consecutive patients with documented LE-PAD (ankle/brachial index ≤0.90) attending our outpatient clinic for intermittent claudication. For each patient we registered cardiovascular risk factors and comorbidities, and measured neutrophil count.
The ultrasound was inconclusive in 3 patients (1.4%), thus 210 patients (169 males, 41 females, mean age 65.9 ± 9.8 yr) entered the study. Overall, AAA was present in 19 patients (9.0%), with a not significant higher prevalence in men than in women (10.1% vs 4.9%, p = 0.300). Patients with AAA were older (71.2 ± 7.0 vs 65.4 ± 9.9 years, p = 0.015), were more likely to have hypertension (94.7% vs 71.2%, p = 0.027), and greater neutrophil count (5.5 [4.5 – 6.2] vs 4.1 [3.2 – 5.5] x103/μL, p = 0.010). Importantly, the c-statistic for neutrophil count (0.73, 95% CI 0.60 – 0.86, p =0.010) was higher than that for age (0.67, CI 0.56–0.78, p = 0.017). The prevalence of AAA in claudicant patients with a neutrophil count ≥ 5.1 x103/μL (cut-off identified at ROC analysis) was as high as 29.0%.
Prevalence of AAA in claudicant patients is much higher than that reported in the general population. Ultrasound screening should be considered in these patients, especially in those with an elevated neutrophil count.