Surveillance outcomes of small XXXX identified from a large screening program.

@entity1 @entity717 @entity1028
OBJECTIVE: Surveillance of @entity1 identified with small @entity1028 ( @entity1028 ) from an @entity1028 screening program poses a challenge for health systems because of numerous @entity1 follow-ups. This study evaluates the surveillance outcomes of @entity1 identified with small @entity1028 from a large screening program. METHODS: A retrospective chart review of all @entity1 screened for small @entity1028 (3.0-5.4  cm) from 2007 to 2011 was conducted. @entity1 with small @entity1028 and no previous history of repair were tracked for follow-up using the 2013 RESCAN follow-up guidelines according to aortic diameter (3.0-3.9  cm, 3  years; 4.0-4.4  cm, 2  years; 4.5-5.4  cm, 1  year). Socioeconomic factors that may influence the follow-up rate and all-cause mortality after screening, including marital status, distance to hospital from residence, estimated household income, and @entity717 status, were also evaluated. RESULTS: A total of 568 @entity1 (mean     standard deviation, 73.4     7.2  years old) with small @entity1028 (3.6     0.6  cm) were analyzed. @entity1 follow-up rate was 65.1% (n  = 370 of 568). Reasons for follow-up failure were lack of the physician's ordering a scan (n  = 139; 70.2%), delayed ordering of scans (n  = 36; 18.2%), @entity1 no-show (n  = 18; 9.1%), or @entity1 death before follow-up (n  = 5; 2.5%). Of all @entity1 -specific factors, @entity1 with smaller diameters were unlikely to achieve follow-up scans (P  < .001). A significantly higher risk of all-cause mortality was found for @entity1 with no ultrasound follow-up scan (hazard ratio [HR], 0.369; P  < .001), assisted living (HR, 0.381; P  < .001), older age (HR,  1.04; P  = .001), and lower household incomes (HR, 0.989; P  = .01). CONCLUSIONS: The follow-up rate of @entity1 with small @entity1028 was poor at 65.1%. The data indicate that socioeconomic factors do not significantly affect follow-up success. Therefore, physician ordering of scans may exert the greatest influence on follow-up rates in @entity1 with small @entity1028 . Automatic ordering of follow-up scans for @entity1 with small AAAs is proposed to improve follow-up rates.
