ED physicians can screen for AAA, study finds
5/7/2007
By: Erik L. Ridley
Emergency physicians are capable of handling ultrasound screening for abdominal aortic aneurysm (AAA), according to researchers from Yale University in New Haven, CT.
"Emergency physicians can quickly and accurately screen for AAAs in at-risk patents, allowing for arrangement of appropriate follow-up," said Dr. Scott Holliday of Yale's section of emergency medicine. He presented the research at the 2007 American Institute of Ultrasound in Medicine (AIUM) meeting in New York City.
The Yale researchers conducted a prospective trial to study the feasibility and cost-effectiveness of screening performed by emergency physicians (EPs) on at-risk patients. The study included 179 male patients over 60 years of age with one or more risk factors for AAA, and who presented to the emergency department (ED) with an unrelated complaint.
The EPs who performed the ultrasound exam received minimum training of didactic instruction, specific instructions for an AAA exam, and had completed five studies. Studies were performed using a 3-5 MHz curvilinear probe using either an EnVisor scanner (Philips Medical Systems, Andover, MA) or a system from B-K Medical Systems of Copenhagen, Denmark.
The physicians examined the aorta from the celiac axis to the bifurcation, and rated the exam as complete, limited, or inadequate. For the purposes of the study, AAA was defined as a maximum diameter of 3 cm or more.
Those patients with AAAs were provided follow-up with a vascular surgeon, and contacted to confirm compliance. The primary investigators recorded all studies and reviewed them later for compliance.
Of the 179 patients, 77% were Caucasian, 19% were African American, and 12% were Hispanic. The average age was 73.6, and risk factors included smoking (76%), hypertension (70%), diabetes (26%), peripheral vascular disease (18%), and a family history of AAAs (3%).
The scans were rated as complete in 61% of the cases, limited in 34%, and inadequate in 4%, Holliday said. The studies were completed in an average time of 129 seconds, with a median of 103 seconds.
During the research, 13 (7.3%) AAAs were found, the sizes of which averaged 4 cm (with a median of 3.7 cm). In those patients, the average time to complete the study was 141 seconds (with a median of 138 seconds). So far, 10 of those patients have received formal imaging in follow-up, and all had AAAs with average discrepancy of 0.6 (median 0), he said.
Holliday acknowledged limitations of the study, including the small sample size, the use of a convenience sample, and reliance on only men for the study. Future research directions could involve cost modeling, as well as community outreach and awareness initiatives, Holliday said.
By Erik L. Ridley
AuntMinnie.com staff writer
May 7, 2007
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ED physicians can screen for AAA, study finds
研究发现急诊科医师能对腹主动脉瘤患者进行筛查
5/7/2007
By: Erik L. Ridley
Emergency physicians are capable of handling ultrasound screening for abdominal aortic aneurysm (AAA), according to researchers from Yale University in New Haven, CT.
康涅狄格州纽黑文市耶鲁大学的研究者认为，急诊内科医师能使用超声对腹主动脉瘤(AAA)进行筛查。
"Emergency physicians can quickly and accurately screen for AAAs in at-risk patents, allowing for arrangement of appropriate follow-up," said Dr. Scott Holliday of Yale's section of emergency medicine. He presented the research at the 2007 American Institute of Ultrasound in Medicine (AIUM) meeting in New York City.
“急诊内科医师能够快速、准确地从高危人群中筛查出腹主动脉瘤患者，考虑到可以适当地安排随访，” 耶鲁大学急救医学部的Dr. Scott Holliday说道。纽约举办的“2007年美国医用超声研究所会议”上他介绍了这项研究。
The Yale researchers conducted a prospective trial to study the feasibility and cost-effectiveness of screening performed by emergency physicians (EPs) on at-risk patients. The study included 179 male patients over 60 years of age with one or more risk factors for AAA, and who presented to the emergency department (ED) with an unrelated complaint.
耶鲁大学研究人员作了一项前瞻性试验来研究开展急诊内科医师对高危病人进行筛查的可行性和成本-效果如何。此研究选择179例60岁以上的男性患者，他们都有一个或多个可引起AAA的危险因素，并且他们是因为与AAA不相关的主诉来急诊科就诊。
The EPs who performed the ultrasound exam received minimum training of didactic instruction, specific instructions for an AAA exam, and had completed five studies. Studies were performed using a 3-5 MHz curvilinear probe using either an EnVisor scanner (Philips Medical Systems, Andover, MA) or a system from B-K Medical Systems of Copenhagen, Denmark.
开展超声检查的急诊内科医师只接受了最小量的有关AAA检查的相关教育资料的学习及特殊技术的训练，并完成五次检测。这些操作须用EnVisor扫描仪(Philips Medical Systems, Andover, MA)或B-K Medical Systems of Copenhagen, Denmark的一个系统的3-5 MHz曲线探针完成。
The physicians examined the aorta from the celiac axis to the bifurcation, and rated the exam as complete, limited, or inadequate. For the purposes of the study, AAA was defined as a maximum diameter of 3 cm or more.
急诊内科医师检查了从腹腔干到分叉处的大动脉血管，这项检查结果有完整的，局限的，也有不充分的。为了实现研究的目的，规定AAA的最大直径为3cm左右。
Those patients with AAAs were provided follow-up with a vascular surgeon, and contacted to confirm compliance. The primary investigators recorded all studies and reviewed them later for compliance.
要求那些AAAs患者随访脉管外科医师，并通过交流加强医从性。初期的研究者记录下所有研究资料并且之后要检查他们的医从性。
Of the 179 patients, 77% were Caucasian, 19% were African American, and 12% were Hispanic. The average age was 73.6, and risk factors included smoking (76%), hypertension (70%), diabetes (26%), peripheral vascular disease (18%), and a family history of AAAs (3%).
这179例受试者中，77%是高加索人（白种人），19%是来自非洲的美国人（黑人），和12%的西班牙人。平均年龄为73.6岁，危险因素包括吸烟(76%)，高血压(70%)，糖尿病(26%)，周围血管疾病(18%)，和有AAAs家族史(3%)。
The scans were rated as complete in 61% of the cases, limited in 34%, and inadequate in 4%, Holliday said. The studies were completed in an average time of 129 seconds, with a median of 103 seconds.
Holliday称，病患扫描结果完整的占61%，局限的占34%，不充分的占4% 。完成这些检测的平均时间是129秒，时间中位数为103秒。
During the research, 13 (7.3%) AAAs were found, the sizes of which averaged 4 cm (with a median of 3.7 cm). In those patients, the average time to complete the study was 141 seconds (with a median of 138 seconds). So far, 10 of those patients have received formal imaging in follow-up, and all had AAAs with average discrepancy of 0.6 (median 0), he said.
他还说，这次研究中发现13例(7.3%)AAAs患者，AAA平均直径为4 cm(中位数是 3.7 cm)。对那些病人，完成检测的平均耗时为141秒（中时间位数为138秒）。到目前为止，有10例病人接受过正式的影像学随访，并且都患了AAAs，平均误差为0.6(中值为 0)。
Holliday acknowledged limitations of the study, including the small sample size, the use of a convenience sample, and reliance on only men for the study. Future research directions could involve cost modeling, as well as community outreach and awareness initiatives, Holliday said.
Holliday承认这次试验的缺陷，包括样本太小，没有按随机原则而只选方便的样本，只研究了男性患者。他说，将来的研究方向应该包括建立成本模拟，同时要进行社区上门调查和宣传使人们主动检查。
编译：
研究发现急诊部内科医师能够筛查腹主动脉瘤
Dr. Scott Holliday等New Haven, CT耶鲁大学的研究者试验发现，急诊内科医师能使用超声对腹主动脉瘤(AAA)进行筛查。（By: Erik L. Ridley AuntMinnie.com staff writer May 7, 2007网络版）
耶鲁大学研究人员选择179例并非因AAA相关的主诉来急诊科就诊的60岁以上， 伴有一个或多个可引发AAA危险因素的男性患者，进行试验并观察开展急诊内科医师对高危病人进行筛查的可行性和成本-效果如何。
这179例受试者中，77%是高加索人（白种人），19%是来自非洲的美国人（黑人），和12%的西班牙人。平均年龄为73.6岁，危险因素包括吸烟(76%)，高血压(70%)，糖尿病(26%)，周围血管疾病(18%)，和有AAAs家族史(3%)。
开展超声检查的急诊内科医师只接受了最小量的有关AAA检查的相关教育资料的学习及特殊技术的训练，并完成五次检测操作。这些操作须用EnVisor扫描仪(Philips Medical Systems, Andover, MA)或B-K Medical Systems of Copenhagen, Denmark的一个系统的3-5 MHz曲线探针完成。这些急诊内科医师检查了患者从腹腔干到分叉处的大动脉血管，不过检查结果有完整的，局限的，也有不充分的。
为了实现研究的目的，规定AAA的最大直径为3cm左右。实验也要求那些AAAs患者随访脉管外科医师，并通过交流加强医从性。初期的研究者记录下所有研究资料，之后要检查他们的医从性。
Holliday称，病患扫描结果完整的占61%，局限的占34%，不充分的占4% 。完成这些检测的平均时间是129秒，时间中位数为103秒。 在研究中发现13例(7.3%)AAAs患者， AAA平均直径为4 cm(中位数是 3.7 cm)。完成那些病人的检测平均耗时为141秒（中时间位数为138秒） 。到目前为止，有10例病人接受过正式的影像学随访，并且都患了AAAs，平均误差为0.6(中值为 0)。
Holliday承认这次试验存在很多缺陷，包括样本太小，没有按随机原则而只选方便的样本，只研究了男性患者。他说，将来的研究方向应该包括建立成本模拟，同时要进行社区上门调查和宣传使人们主动检查。纽约举办的“2007年美国医用超声研究所会议”上他介绍了这项研究。(丁香)
个人观点，仅供参考：
ED physicians can screen for AAA, study finds
研究发现急诊部内科医师能够筛查腹主动脉瘤
研究表明急诊科医生能对腹主动脉瘤患者进行筛查
New Haven, CT
康涅狄格州纽黑文市
screen for AAAs in at-risk patents,
筛查出腹主动脉瘤（AAAs）高危病人
从高危人群中筛查出腹主动脉瘤患者
allowing for arrangement of appropriate follow-up,
可根据情况安排适当的随访
考虑到可以适当地安排随诊
He presented the research
他提出了这项研究
他介绍了这项研究
The Yale researchers
耶鲁大学研究员
耶鲁大学研究人员
The study included 179 male patients over 60 years of age with one or more risk factors for AAA, and who presented to the emergency department (ED) with an unrelated complaint.
此研究选择179例60岁以上的男性患者，他们都伴有一个或多个可引起AAA的危险因素，并且他们是因为与AAA不相关的症状来急诊科就诊。
这项研究共有179例60岁以上的男性患者。他们都有一个或多个可引起腹主动脉瘤的危险因素，而且都是由于与AAA无关的主诉来急诊科就诊的。
谢谢假行家 ！ ！
有所改动了。
