Kevin C. Chun BS, Kai Y. Teng BS, Elyse N. Van Spyk BS, John G. Carson MD, Eugene S. Lee MD PhD
University of California, Davis and Sacramento VA Medical Center; Sacramento, CA.
OBJECTIVES: In 2007, Medicare guidelines were established to identify persons at risk for the presence of an abdominal aortic aneurysm (AAA). The purpose of this study was to evaluate the implementation of the SAAAVE Act in identifying patients at risk for AAA within a 5-year period in clinical practice.
METHODS: Data was extracted from a regional Veterans Affairs Healthcare Network to identify all veteran males 65-75 years of age who smoked greater than 100 cigarettes during their lifetime. In 2007, an AAA screening mandate was implemented allowing patients meeting screening criteria to be evaluated for AAA as part of the patient’s health maintenance. AAA is identified as an aortic diameter size of 3.0 cm or greater. Clinician adherence to screening protocols and timely referral for aneurysms greater than 5.5 cm were also evaluated.
RESULTS: A total of 9,788 patients (71.5 ± 5.6 years of age) were screened for an AAA over a 5-year period from January 1, 2007 to December 31, 2011. A total of 698 aneurysms (7.1%) were found (Table). Timely referrals were made on 44 patients with aneurysms greater than 5.5 cm. A total of 2,828 patients (28.9%) were inappropriately screened: 421 patients were too young, 2,250 patients were too old, 36 patients were women, and 121 patients without aneurysms had multiple screenings.
CONCLUSIONS: The long implementation of the AAA screening has allowed greater deviation from Medicare guidelines that increased the number of inappropriate screenings, mandating further AAA screening education for primary care providers.
AUTHOR DISCLOSURES: K. Chun, Nothing to disclose; K. Teng, Nothing to disclose; E. Van Spyk, Nothing to disclose; J. Carson, Nothing to disclose; E. Lee, Nothing to disclose.
Posted April 2012