Waiting Too Long

iStock-486792042Watching and waiting may take place too long in the UK when it comes to abdominal aortic aneurysms (AAA), a study Rick and I discuss on PodMed this week and as published in NEJM reveals, since a number of dire outcomes seem to result when repair is delayed until a certain size aneurysm is reached And as I chortle to Rick, it isn't often our interventional approach to many medical conditions is validated when compared to more conservative strategies, so this study is noteworthy to me in that regard.

Data from almost 30,000 folks who underwent AAA repair in the UK was compared in this study to almost 280,000 records from those with the same condition in the US. This was during the time period from 2005 through 2012. The impact of the higher thresholds for treatment in the UK was examined through the lens of three outcomes: death relative to the aneurysm, hospitalization relative to AAA, and likelihood of repair. The study found that AAA repair was less likely to be undertaken in the UK, that aneurysm-related death was almost four times more likely in the UK, and that hospitalization due to rupture was more than twice as likely across the pond. The average threshold for treatment was 58.3 millimeters domestically versus 63.1mm in the UK. Hmmm.  Seems like operating sooner rather than later is a better strategy, and Rick and I also note that screening, especially for older men who are current or former smokers, is also important.

Other topics this week include Symptoms and Satisfaction of Patients in the PROWL StudiesHip and Pelvic Fracture Risk Associated With Antihypertensive Medications, and a look a mumps in the US currently from MMWR http://www.cdc.gov/mmwr/index.html, along with measles surveillance.  Until next week, y'all live well.

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