How can an AAA screening program be implemented in Germany?

Heidemann, Franziska; Meier, Uwe; Kölbel, Tilo; Atlihan, Gülsen; Debus, Eike Sebastian

doi:10.1007/s00772-014-1392-0

Cited by 2 publications

(2 citation statements)

References 3 publications

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“…30-day mortality after an elective operation was similar in all three centers, but the lethal outcomes due to rupture was significantly higher in Ryazan and Dushanbe. This fact in our opinion may be a result of more frequent application of screening program in Cologne [11]. As well as the known higher incidence of AAA in the western world as compared to the developing countries including Asian countries [6,12].…”

Section: Discussionmentioning

confidence: 90%

Demographic Differences in Patients With Abdominal Aortic Aneurysm in Different Countries: Germany, Tajikistan and Russian Federation

Калмыков¹,

Ahmad²,

Suchkov³

et al. 2021

Novosti Khirurgii

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Objective. To compare the demographics, comorbidities and risk factors in patients with abdominal aortic aneurysm (AAA) treated in three different communities; Germany, Tajikistan and Russian Federation. Methods. A retrospective comparative study including patients with an infrarenal AAA who were treated with either endovascular aneurysm repair (EVAR) or open repair (2011-2015) in Cologne, Dushanbe and Ryazan was done. A total number of 711 patients, 499 from Cologne, 46 from Dushanbe and 166 from Ryazan were included in the study. Demographic data including age, gender, body mass index (BMI), comorbidities (diabetes, coronary artery disease (CAD)), hypertension, cerebrovascular disease, chronic obstructive pulmonary disease (COPD, smoking), actual treatment as well as the diameter of the abdominal aorta were collected, retrospectively. Results. There was no statistically significant difference in AAA prevalence with respect to gender between the study centers. Similarly, the BMI did not differ significantly between these 3 centers. Though, the patients from Cologne were older than those from Dushanbe and Ryazan. Moreover, the number of patients treated due to ruptured aneurysm was significantly lower in Cologne in comparison to the other two centers (P<0.05). The AAA-diameter of patients in Ryazan and Dushanbe was greater than that found in Cologne. Regarding the actual medication that patients were presented with, antiplatelet-aggregation medication, statin and beta blockers were used significantly more often in Cologne. Patients from Tajikistan had COPD more often than patients from the other centers. Conclusion. The prevalence of comorbidities, risk factors as well as medication in patients with infrarenal abdominal aortic aneurysm is different in the various geographical regions. What this paper adds The study demonstrates that the prevalence of comorbidities, risk factors as well as medication in patients with infrarenal abdominal aortic aneurysm is different in the various geographical regions. These differences have been firstly demonstrated in patients from the Russian Federation and Tajikistan.

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Section: Discussionmentioning

confidence: 90%

Demographic Differences in Patients With Abdominal Aortic Aneurysm in Different Countries: Germany, Tajikistan and Russian Federation

Калмыков¹,

Ahmad²,

Suchkov³

et al. 2021

Novosti Khirurgii

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“…European between-country variations have also been described for other diagnostic tests in primary care13; thus, variations in access to in-house ultrasound may be caused by national differences in the organisation of primary care. For example, the high proportion in Finland may be explained by larger healthcare centres with more advanced equipment,16 whereas in Germany PCPs are taught how to use ultrasonography for abdominal examinations 21. Whether the gate-keeper function that PCPs have in some countries,12 the specialty training system for PCPs, the PCP’s ultrasound training or the waiting time to see a specialist is important is unclear since we did not collect data on these issues.…”

Section: Discussionmentioning

confidence: 99%

Primary care physicians’ access to in-house ultrasound examinations across Europe: a questionnaire study

et al. 2019

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ObjectiveThe overall objective of this study was to examine the differences in ultrasound availability in primary care across Europe.DesignCross-sectional study.SettingPrimary care.ParticipantsPrimary care physicians (PCPs).Primary and secondary outcomes measuresThe primary aim was to describe the variation in in-house primary care ultrasonography availability across Europe using descriptive statistics. The secondary aim was to explore associations between in-house ultrasonography availability and the characteristics of PCPs and their clinics using a mixed-effects logistic regression model.ResultsWe collected data from 20 European countries. A total of 2086 PCPs participated, varying from 59 to 446 PCPs per country. The median response rate per country was 24.8%. The median (minimum–maximum) percentage of PCPs across Europe with access to in-house abdominal ultrasonography was 15.3% (0.0%–98.1%) and 12.1% (0.0%–30.8%) had access to in-house pelvic ultrasonography with large variations between countries. We found associations between in-house abdominal ultrasonography availability and larger clinics (OR 2.5, 95% CI 1.2 to 4.9) and clinics with medical doctors specialised in areas, which traditionally use ultrasonography (OR 2.1, 95% CI 1.1 to 3.8). Corresponding associations were found between in-house pelvic ultrasonography availability and larger clinics (OR 1.9, 95% CI 1.3 to 2.7) and clinics with medical doctors specialised in areas, which traditionally use ultrasonography (OR 3.0, 95% CI 1.8 to 5.1). Additionally, we found a negative association between urban clinics and in-house pelvic ultrasound availability (OR 0.5, 95% CI 0.2 to 0.9).ConclusionsAcross Europe, there is a large variation in PCPs’ access to in-house ultrasonography and organisational aspects of primary care seem to determine this variation. If evidence continues to support ultrasonography as a front-line point-of-care test, implementation strategies for increasing its availability in primary care are needed. Future research should focus on facilitators and barriers that may affect the implementation process.

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How can an AAA screening program be implemented in Germany?

Cited by 2 publications

References 3 publications

Demographic Differences in Patients With Abdominal Aortic Aneurysm in Different Countries: Germany, Tajikistan and Russian Federation

Demographic Differences in Patients With Abdominal Aortic Aneurysm in Different Countries: Germany, Tajikistan and Russian Federation

Primary care physicians’ access to in-house ultrasound examinations across Europe: a questionnaire study

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