Abdominal aortic aneurysm. Prevalence and associated risk factors in a population of patients hospitalised in Internal Medicine

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Prevalence and associated risk factors in a population of patients hospitalised in Internal Medicine" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "455" "paginaFinal" => "460" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "S.L. Belloch García" "autores" => array:1 [ 0 => array:3 [ "nombre" => "S.L." "apellidos" => "Belloch García" "email" => array:1 [ 0 => "sbelloch@hotmail.com" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario de La Ribera, Alzira (Valencia), Spain" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Aneurisma de aorta abdominal. Prevalencia y factores de riesgo asociados en una población de pacientes ingresados en Medicina Interna" ] ] "textoCompleto" => "BackgroundAbdominal aortic aneurysm (AAA) is a potentially severe condition that is defined by segmental dilation of the abdominal aorta with a diameter ≥30mm.<a class="elsevierStyleCrossRef" href="#bib0135">1</a>Age, the male sex, a personal history of atherosclerotic disease, tobacco use, hypertension, obesity, dyslipidemia, coronary artery disease, atherosclerosis and a family history of AAA are risk factors associated with the presence of this condition.<a class="elsevierStyleCrossRefs" href="#bib0140">2–4</a> Tobacco use is the most important modifiable risk factor,<a class="elsevierStyleCrossRef" href="#bib0150">4</a> and the risk of AAA is 4times greater in men than in women. In men, AAA usually starts at 50 years of age, while in women, the disease starts at 60–70 years of age, with the incidence increasing significantly with each decade.<a class="elsevierStyleCrossRef" href="#bib0155">5</a> Four studies conducted between 1988 and 1999 showed a prevalence of AAA of 4–7.2% in men older than 65 years.<a class="elsevierStyleCrossRefs" href="#bib0160">6–9</a> Studies in Spain have estimated a prevalence of AAA of 2.6–4.7% in the general population of men older than 65 years.<a class="elsevierStyleCrossRefs" href="#bib0180">10–12</a> Since 2000, several studies have detected a reduction in the prevalence of the disease of up to 2.3%.<a class="elsevierStyleCrossRefs" href="#bib0195">13,14</a> This tendency is probably the result of a change in risk factors, particularly tobacco use.<a class="elsevierStyleCrossRef" href="#bib0205">15</a> In selected populations, however, this prevalence remains higher. In a study with patients hospitalized for acute coronary syndrome and with coronary lesions of at least 50%, the prevalence was 6.6% for those older than 50 years.<a class="elsevierStyleCrossRef" href="#bib0210">16</a> In Spain, the rate is 5.1% for patients (regardless of sex) who underwent an echocardiogram for any reason<a class="elsevierStyleCrossRef" href="#bib0215">17</a> and 5.88% for primary care populations with a history of arterial hypertension or tobacco use.<a class="elsevierStyleCrossRef" href="#bib0220">18</a>The natural history of AAA is characterized by progressive expansion of the aneurysm, with an estimated growth rate of 1–6mm/year,<a class="elsevierStyleCrossRef" href="#bib0225">19</a> although this can vary.<a class="elsevierStyleCrossRef" href="#bib0230">20</a>Rupture usually entails a mortality rate greater than 60–70%.<a class="elsevierStyleCrossRef" href="#bib0135">1</a> For aneurysms smaller than 5.5cm, the annual risk of rupture is <1%. However, this risk increases starting at 5.5cm, reaching 32.5% when the size of the aneurysm is ≥7cm.<a class="elsevierStyleCrossRef" href="#bib0235">21</a>During the growth phase, AAA can be suspected when faced with the presence of a pulsatile abdominal mass, but the sensitivity of the physical examination is poor. The initial diagnostic technique for AAA is ultrasonography, with a sensitivity of 95% and specificity of 100%. CT is employed for the preoperative and postoperative assessment. The dismal prognosis of a torn AAA (mortality of 60–70%) is in sharp contrast to the excellent survival rate (>95%) after elective surgery of an undamaged aneurysm. These data, along with the silent course of AAAs and the possibility of a simple diagnosis through ultrasonography, led to the consideration of screening for high-risk populations (such as individuals older than 65 years, smokers and those with a family history of AAAs).<a class="elsevierStyleCrossRef" href="#bib0135">1</a> Several studies have demonstrated the benefit of AAA screening through ultrasonography.<a class="elsevierStyleCrossRefs" href="#bib0160">6–9</a> A meta-analysis concluded that implementing screening in men older than 65 years was associated with a 45% reduction in AAA-associated mortality and with a 2% reduction in overall mortality.<a class="elsevierStyleCrossRef" href="#bib0240">22</a> A number of countries have implemented AAA screening programs. These programs are generally directed at men older than 65 years and especially those who are or have been smokers and who have a family history of AAA.<a class="elsevierStyleCrossRefs" href="#bib0245">23,24</a> In the absence of a population AAA screening plan, opportunistic screening can be a good alternative, as is ultrasonography for other reasons and measuring the aneurysm during the implementation of an echocardiogram.<a class="elsevierStyleCrossRefs" href="#bib0135">1,16,17</a> Performing clinical ultrasonography (ultrasound examination performed by the physician who is directly responsible for the patient) during hospitalization can also be a good opportunity for performing a AAA screening. The agreement between the AAA diagnosis using clinical ultrasonography and conventional ultrasonography is 100%.<a class="elsevierStyleCrossRefs" href="#bib0180">10,18,25</a>We have found no published studies on the prevalence of AAA in patients hospitalized for general medical diseases. However, we did find publications on the prevalence of patients hospitalized for heart disease.<a class="elsevierStyleCrossRefs" href="#bib0210">16,25</a> In Spain, the published studies cover nonhospitalized populations.<a class="elsevierStyleCrossRefs" href="#bib0180">10–12,17</a> Patients who are admitted to the internal medicine departments are at risk of having an AAA. It is therefore important to determine its prevalence in this setting.Moreover, understanding the risk factors associated with the presence of AAA in this setting can facilitate patient selection for performing an ultrasound.In the field of internal medicine, the incorporation of clinical ultrasonography has represented a technological breakthrough, which was made possible thanks to the development of increasingly smaller and less expensive portable equipment. During the hospitalization of a patient with a risk of AAA, clinical ultrasonography can facilitate the early diagnosis without overloading the radiology departments.<a class="elsevierStyleCrossRef" href="#bib0255">25</a>Materials and methodsHypothesis and objectivesPerforming an abdominal ultrasound on patients older than 50 years hospitalized in an internal medicine department helps diagnose patients with asymptomatic AAA.Primary objectivesTo understand the prevalence of AAA, using clinical ultrasonography, in the population of patients older than 50 years hospitalized in internal medicine.To understand the risk factors associated with the presence of AAA.Secondary objectiveTo determine the positive predictive value of clinical ultrasonography in detecting AAA in this population.DesignObservational, cross-sectional, single-center study.PopulationThe patients were consecutively included and randomly assigned to a physician. These patients were older than 50 years and hospitalized in the Department of Internal Medicine of Hospital de La Ribera. This department, which has a marked hospitalist character, admits all patients with medical disease for any cause.Exclusion criteria:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">-Patients already diagnosed with AAA</li><li class="elsevierStyleListItem" id="lsti0010">-Patients for whom the current hospitalization is the result of the diagnosis of AAA.</li><li class="elsevierStyleListItem" id="lsti0015">-Patients with stage 7 dementia on the Global Deterioration Scale.</li><li class="elsevierStyleListItem" id="lsti0020">-Patients with active neoplasia.</li></ul>Sample size calculationTo calculate the sample size, we considered an expected AAA prevalence of 6% based on the prevalence observed in other studies in specific populations. Along with a 95% confidence level and a precision of 3%, we estimated a sample size of 241 patients.InterventionA clinical ultrasound was performed of the abdominal aorta, and the aorta's diameter was measured. In the positive cases, conventional ultrasonography or CT was performed to confirm the diagnosis.The ultrasound was performed at the point-of-care by a medical internist with training in clinical ultrasonography and with a portable ultrasound (EDAN model DUS 60) with a 3.5-mHz convex probe.VariablesDependent variableThe dependent variable was the presence or absence of AAA, based on whether the diameter of the aorta reaches or fails to reach 3cm.Independent variables extracted from the medical historyAge, sex, history of arterial hypertension, dyslipidemia, diabetes, obesity, tobacco use, ischemic heart disease, stroke or intermittent claudication and a first-degree family history of AAA or of early-onset ischemic heart disease. We also included creatinine clearance prior to admission (MDRD-4). During the hospitalization, we measured the ankle brachial index (ABI).Statistical analysisDescriptive analysisThe quantitative variables are listed with the measures of central tendency (mean) and of dispersion (standard deviation, interquartile range). The qualitative variables are listed with absolute and relative frequencies expressed in percentages.Bivariate analysisThe various independent variables were related to the presence or absence of AAA.<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0025">-The quantitative variables were compared regarding the presence or absence of AAA with Student's t-test or its equivalent nonparametric Mann–Whitney U test.</li><li class="elsevierStyleListItem" id="lsti0030">-The categorical variables were compared with chi-squared tests or Fisher's exact test.</li></ul>Multivariate analysisWe determined the independent relationship of the explanatory variables with AAA, using a logistic regression model.The analysis was performed using the SPSS statistical package.Ethical aspectsThe research project was approved by the Research Committee of Hospital de La Ribera.Informed consent was obtained from all patients for their inclusion in the project.ResultsPatient selection occurred between October 2016 and June 2017.Of the patients who met the inclusion criteria, 2 did not give their consent, and the abdominal aorta could not be properly visualized in 3 patients.A total of 241 patients were included, 7 of whom were diagnosed with previously unknown AAA, which represents 2.9% (95% CI 0.8–5%). The diagnosis was confirmed by CT or ultrasonography performed by the Department of Radiology (positive predictive value, 100%).The distribution of the study variables is shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>All cases were men with a current or past history of tobacco use and an age of 65 years or older (the prevalence in the patient subgroup older than 65 years was 3.9%).In the bivariate analysis, the relevant associations were being male (OR, 9.39), present or past tobacco use (OR, 13.08), a history of ischemic heart disease (OR, 5.6; 95% CI 1.21–25.91; p<.05) and the presence of an ABI<0.9 (OR, 12.50; 95% CI 2.34–66.77; p<.05). In the case of sex and tobacco use, their contingency tables contain a box with the value of zero. Their odds ratio was therefore calculated by approximation. In these cases, the confidence interval was not calculable.We performed a multivariate analysis using the logistic regression method and included as independent variables the history of ischemic heart disease and the presence of an ABI<0.9. We excluded the variables sex and tobacco use to exclude incongruous estimates, given that the 2 variables discriminated perfectly the 2 categories of the dependent variable (all cases with AAA were men with a history of tobacco use). The variable independently associated with the presence of AAA was an ABI<0.9 (OR, 10.758; 95% CI 1.968–58.815; p=.006).DiscussionOur series found 7 cases (2.9%) of previously undiagnosed AAA; however, we cannot compare this result with other studies because we could not find studies with populations similar to ours. We can say, however, that the prevalence is in the lower range according to that estimated in other series, even if we restrict the prevalence to those older than 65 years.<a class="elsevierStyleCrossRefs" href="#bib0160">6–12,16,17</a> This is consistent with the reduction in the incidence rate referred to in other articles, which is possibly due to a reduction in tobacco consumption.<a class="elsevierStyleCrossRefs" href="#bib0195">13,14</a>In terms of sex, all cases of AAA involved men. This association is widely validated in the literature,<a class="elsevierStyleCrossRefs" href="#bib0140">2–5,17</a> indicating a low incidence among women, which is why they are not included in population screening programs.<a class="elsevierStyleCrossRefs" href="#bib0200">14,23</a>Age is a known risk factor of AAA.<a class="elsevierStyleCrossRefs" href="#bib0140">2–4,17</a> Although age showed no correlation with the presence of AAA in the statistical analysis, all cases involved patients older than 65 years, falling within the age range proposed for screening programs.<a class="elsevierStyleCrossRefs" href="#bib0200">14,23</a>The association with tobacco use is another strongly associated factor,<a class="elsevierStyleCrossRefs" href="#bib0140">2–4,11,17</a> as was observed in our series and having the highest OR value.Arteriosclerosis, established in the form of ischemic heart disease or peripheral vascular insufficiency, was also related to AAA. The association with ischemic heart disease<a class="elsevierStyleCrossRefs" href="#bib0145">3,15</a> is of special relevance when the prevalence of AAA reaches 6.6% in patients with acute coronary syndrome.<a class="elsevierStyleCrossRef" href="#bib0210">16</a> Lastly, the relationship with an ABI<0.9 has also been reported,<a class="elsevierStyleCrossRefs" href="#bib0180">10,16</a> a finding we were able to observe.A family history of AAA is another known factor<a class="elsevierStyleCrossRefs" href="#bib0140">2,3</a>; however, we found no association with this factor due to the small number of patients with this antecedent.Unlike other series, we found no association with other factors such as diabetes,<a class="elsevierStyleCrossRefs" href="#bib0180">10,11</a>.<a class="elsevierStyleCrossRef" href="#bib0215">17</a> dyslipidemia,<a class="elsevierStyleCrossRefs" href="#bib0145">3,10,11</a> obesity<a class="elsevierStyleCrossRef" href="#bib0145">3</a> and hypertension.<a class="elsevierStyleCrossRefs" href="#bib0145">3,10</a>Other studied factors (stroke,<a class="elsevierStyleCrossRefs" href="#bib0145">3,11,17</a> renal function,<a class="elsevierStyleCrossRefs" href="#bib0145">3,11,17</a> and a family history of early-onset cardiovascular disease) that were not known to be associated with AAA were also not included in the analysis.In the multivariate analysis, we did not include sex or a history of tobacco use due to the fact that they perfectly discriminated the presence of AAA. We did include the history of ischemic heart disease and the presence of an ABI<0.9, the latter of which was shown to be independently related. This association has also been found in other series,<a class="elsevierStyleCrossRef" href="#bib0185">11</a> with a AAA prevalence rate of 9% in patients with ABI≤0.9.<a class="elsevierStyleCrossRef" href="#bib0260">26</a>Given the reliability for the diagnosis of AAA with clinical ultrasonography using portable equipment,<a class="elsevierStyleCrossRefs" href="#bib0180">10,18,25</a> we decided to perform confirmation ultrasonography only in cases in which AAA was observed in the clinical ultrasonography. Although this could detract value by not being able to calculate the negative predictive value, the positive predictive value was 100%.ConclusionsFor patients older than 50 years hospitalized in our Department of Internal Medicine, there was a 2.9% prevalence of previously undiagnosed AAA.The data from this study lead us to recommend AAA screening for male patients older than 50 years hospitalized in internal medicine, with a history of tobacco use and an ABI<0.9.The incorporation of clinical ultrasonography can enable the implementation of this screening reliably, inexpensively and without overloading radiology departments.FundingThis project was partially funded by the 2016 Research Grant of the Valencian Internal Medicine Society.Conflicts of interestThe author declares that he has no conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres1118054" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Patients and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1054235" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1118055" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Pacientes y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1054236" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Background" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:8 [ 0 => array:3 [ "identificador" => "sec0015" "titulo" => "Hypothesis and objectives" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Primary objectives" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Secondary objective" ] ] ] 1 => array:2 [ "identificador" => "sec0030" "titulo" => "Design" ] 2 => array:2 [ "identificador" => "sec0035" "titulo" => "Population" ] 3 => array:2 [ "identificador" => "sec0040" "titulo" => "Sample size calculation" ] 4 => array:2 [ "identificador" => "sec0045" "titulo" => "Intervention" ] 5 => array:3 [ "identificador" => "sec0050" "titulo" => "Variables" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0055" "titulo" => "Dependent variable" ] 1 => array:2 [ "identificador" => "sec0060" "titulo" => "Independent variables extracted from the medical history" ] ] ] 6 => array:3 [ "identificador" => "sec0065" "titulo" => "Statistical analysis" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0070" "titulo" => "Descriptive analysis" ] 1 => array:2 [ "identificador" => "sec0075" "titulo" => "Bivariate analysis" ] 2 => array:2 [ "identificador" => "sec0080" "titulo" => "Multivariate analysis" ] ] ] 7 => array:2 [ "identificador" => "sec0085" "titulo" => "Ethical aspects" ] ] ] 6 => array:2 [ "identificador" => "sec0090" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0095" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0100" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0105" "titulo" => "Funding" ] 10 => array:2 [ "identificador" => "sec0110" "titulo" => "Conflicts of interest" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-02-21" "fechaAceptado" => "2018-04-17" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1054235" "palabras" => array:5 [ 0 => "Abdominal aortic aneurysm" 1 => "Prevalence" 2 => "Risk factors" 3 => "Internal Medicine" 4 => "Clinical ultrasonography" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1054236" "palabras" => array:5 [ 0 => "Aneurisma de aorta abdominal" 1 => "Prevalencia" 2 => "Factores de riesgo" 3 => "Medicina Interna" 4 => "Ecografía clínica" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectivesTo determine the prevalence of previously undiagnosed abdominal aortic aneurysm (AAA) in patients hospitalised in a department of internal medicine, as well as the associated risk factors. Patients and methodsAn observational, cross-sectional, single-center, randomized study was conducted on 241 patients hospitalised in Internal Medicine. The patients were older than 50 years, had no previous diagnosis of AAA and underwent clinical ultrasonography. The dependent variable was the presence or absence of an aneurysm. The independent variables were age, sex, cardiovascular risk factors, cardiovascular disease, renal function, ankle brachial index (ABI), family history (first degree) of AAA or of early ischemic heart disease. A bivariate and multivariate analysis was conducted in the statistical analysis. ResultsThe prevalence of AAA was 2.9% (95% CI: 0.8–5). The cases were confirmed through ultrasonography or computed tomography by the Department of Radiology. All patients were men with a history of smoking and with an age≥65 years. The bivariate analysis found an association between being male (OR, 9.39), smoking (OR, 13.08), ischemic heart disease (OR, 5.6; 95% CI: 1.21–25.91; p<.05) and ABI<0.9 (OR, 12.50; 95% CI: 2.34–66.77; p<.05). In the multivariate analysis, the independently associated variable was an ABI<0.9 (OR, 10.758; 95% CI: 1.968–58.815; p=.006). ConclusionsThe prevalence of undiagnosed AAA in patients older than 50 years hospitalised in internal medicine was 2.9%. The data lead us to recommend AAA screening for this population of male patients with a history of smoking and an ABI<0.9. Clinical ultrasonography enables this screening in a reliable manner." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Patients and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "ObjetivosDeterminar la prevalencia de aneurisma de aorta abdominal (AAA), no diagnosticado previamente, en pacientes ingresados en un Servicio de Medicina Interna, así como los factores de riesgo asociados. Pacientes y métodosEstudio observacional, transversal, unicéntrico, aleatorizado de 241 pacientes ingresados en Medicina Interna, mayores de 50 años, sin diagnóstico previo de AAA. Se practicó una ecografía clínica. La variable dependiente fue la presencia o no de aneurisma. Las variables independientes fueron edad, sexo, factores de riesgo cardiovascular, enfermedad cardiovascular, función renal, índice tobillo-brazo (ITB), antecedente familiar de primer grado de AAA o de cardiopatía isquémica precoz. Se realizó un análisis bivariante y multivariante. ResultadosLa prevalencia del AAA fue del 2,9% (IC 95%: 0,8-5). Los casos fueron confirmados mediante ecografía o TAC por el Servicio de Radiología. Todos fueron varones con antecedente de tabaquismo y con edad ≥ 65 años. En el análisis bivariante se asociaron ser varón (OR = 9,39), el tabaquismo (OR = 13,08), cardiopatía isquémica (OR = 5,6; IC 95%: 1,21-25,91; p < 0,05) e ITB inferior a 0,9 (OR = 12,50; IC 95% = 2,34-66,77; p < 0,05). En el análisis multivariante la variable asociada independientemente fue un ITB < 0,9 (OR: 10,758; IC 95%: 1,968-58,815; p = 0,006). ConclusionesLa prevalencia de AAA no diagnosticado en pacientes mayores de 50 años ingresados en Medicina Interna fue del 2,9%. Los datos llevarían a recomendar el cribado de AAA en esta población de pacientes varones, con antecedente de tabaquismo y con un ITB inferior a 0,9. La ecografía clínica posibilitaría este cribado de forma fiable." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Pacientes y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Belloch García S. Aneurisma de aorta abdominal. Prevalencia y factores de riesgo asociados en una población de pacientes ingresados en Medicina Interna. Rev Clin Esp. 2018;218:455–460." ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total n (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Without AAA n (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">With AAA n (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">241 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">234 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age in years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">71.6 (SD 10.92; range, 50–93) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">71.54 (SD, 10.52; range, 50–93) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">72.4 (SD 5.7; range 65–79) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">.991 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age ≥65 years n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">178 (73.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">171 (73.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">.195 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top">Sex n (%)</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">151 (62) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">144 (61) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">.048 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">90 (37) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">90 (38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">NS \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Arterial hypertension \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">166 (68.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">161 (68.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 (71.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Diabetes mellitus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">81 (33.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">78 (33.33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 (42.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">.690 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Dyslipidemia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">94 (39) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">89 (38.03) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 (71.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">.113 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Obesity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">80 (33.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">78 (33.33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (28.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Tobacco use (past or present) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">132 (54.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">125 (53.41) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">.017 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Active \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">47 (19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">45 (19) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (28) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ex-smoker \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">85 (35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">80 (34) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 (71) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Creatinine clearance (MDRD-4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">74.84 (SD, 27.71; range, 7–159) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">75.30 (SD, 27.9; range, 7–159) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">61 (SD, 15.97; range 34–80) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">.057 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Clearance<60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">69 (28.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">67 (28.63) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (28.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ischemic heart disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">49 (20.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">45 (19.23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 (57.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">.033 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Stroke \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">14 (5.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13 (5.55) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 (14.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">.346 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Claudication \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">18 (7.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16 (6.83) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 (28.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">.089 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">First-degree family member with aneurysm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 (0.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 (0.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">First-degree family member with early-onset CVD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 (3.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 (3.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">ABI<0.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">44 (18.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">39 (16.66) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 (71.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">.003 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1907745.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Distribution of variables in the study population." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:26 [ 0 => array:3 [ "identificador" => "bib0135" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "2014 ESC Guidelines on the diagnosis and treatment of aortic diseases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Eerbel" 1 => "V. Aboyans" 2 => "C. Boileau" 3 => "E. Bossone" 4 => "R. Di Bartolomeo" 5 => "H. Eggebrecht" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurheartj/ehu281" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2014" "volumen" => "35" "paginaInicial" => "2873" "paginaFinal" => "2926" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25173340" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0140" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Abdominal aortic aneurysm: pathogenesis and implications for management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Golledge" 1 => "J. Muller" 2 => "A. Daugherty" 3 => "P. Norman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/01.ATV.0000245819.32762.cb" "Revista" => array:6 [ "tituloSerie" => "Arterioscler Thromb Vasc Biol" "fecha" => "2006" "volumen" => "26" "paginaInicial" => "2605" "paginaFinal" => "2613" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16973970" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0145" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The aneurysm detection and management study screening program: validation cohort and final results (Aneurysm Detection and Management Veterans Affairs Cooperative Study Investigators)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F.A. Lederle" 1 => "G.R. Johnson" 2 => "S.E. Wilson" 3 => "E.P. Chute" 4 => "R.J. Hye" 5 => "M.S. Makaroun" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Arch Intern Med" "fecha" => "2000" "volumen" => "160" "paginaInicial" => "1425" "paginaFinal" => "1430" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10826454" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0302283816304377" "estado" => "S300" "issn" => "03022838" ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0150" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk factors for abdominal aortic aneurysms: a 7-year prospective study: the Tromsø Study, 1994–2001" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S.H. Forsdahl" 1 => "K. Singh" 2 => "S. Solberg" 3 => "B.K. Jacobsen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.108.817619" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2009" "volumen" => "119" "paginaInicial" => "2202" "paginaFinal" => "2208" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19364978" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0155" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Increasing prevalence of abdominal aortic aneurysms: a necropsy study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H. Bengtsson" 1 => "D. Bergqvist" 2 => "N.H. Sternby" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur J Surg" "fecha" => "1992" "volumen" => "158" "paginaInicial" => "19" "paginaFinal" => "23" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1348634" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0160" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Multicentre Aneurysm Screening Study (MASS) into the effect of abdominal aortic aneurysm screening on mortality in men: a randomised controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.A. Ashton" 1 => "M.J. Buxton" 2 => "N.E. Day" 3 => "L.G. Kim" 4 => "T.M. Marteau" 5 => "R.A. Scott" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Lancet" "fecha" => "2002" "volumen" => "360" "paginaInicial" => "1531e9" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0165" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Influence of screening on the incidence of ruptured abdominal aortic aneurysm: 5-year results of a randomized controlled study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R.A. Scott" 1 => "N.M. Wilson" 2 => "H.A. Ashton" 3 => "D.N. Kay" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Surg" "fecha" => "1995" "volumen" => "82" "paginaInicial" => "1066" "paginaFinal" => "1070" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7648155" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0170" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Population based randomized controlled trial on impact of screening on mortality from abdominal aortic aneurysm" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.E. Norman" 1 => "K. Jamrozik" 2 => "M.M. Lawrence-Brown" 3 => "M.T. Le" 4 => "C.A. Spencer" 5 => "R.J. Tuohy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bmj.38272.478438.55" "Revista" => array:5 [ "tituloSerie" => "BMJ" "fecha" => "2004" "volumen" => "329" "paginaInicial" => "1259" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15545293" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0175" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hospital costs and benefits of screening for abdominal aortic aneurysms. Results from a randomised population screening trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.S. Lindholt" 1 => "S. Juul" 2 => "H. Fasting" 3 => "E.W. Henneberg" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Eur J Vasc Endovasc Surg" "fecha" => "2002" "volumen" => "23" "paginaInicial" => "55e60" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0180" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalencia del aneurisma de aorta abdominal en varones de 65-80 años de una población rural" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L. Salcedo" 1 => "P. Alcázar" 2 => "J.M. Tenías" 3 => "R. García" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.semerg.2014.01.013" "Revista" => array:7 [ "tituloSerie" => "Semergen" "fecha" => "2014" "volumen" => "40" "paginaInicial" => "425" "paginaFinal" => "430" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25082506" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0959804915007431" "estado" => "S300" "issn" => "09598049" ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0185" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalencia de aneurismas de aorta abdominal en varones de 65 años de la Comarca Interior de Bizkaia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Barba" 1 => "M. Vega de Céniga" 2 => "L. Estallo" 3 => "N. de la Fuente" 4 => "B. Viviens" 5 => "R. Gómez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Angiología" "fecha" => "2011" "volumen" => "63" "paginaInicial" => "18" "paginaFinal" => "24" "itemHostRev" => array:3 [ "pii" => "S1098301515050676" "estado" => "S300" "issn" => "10983015" ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0190" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Despistaje de aneurisma de aorta abdomnial en Atención Primaria" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Álvarez" 1 => "A. Prada" 2 => "C. Bermúdez" 3 => "R. García" 4 => "E. Ruiz" 5 => "J. Urbano" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.semerg.2016.03.003" "Revista" => array:6 [ "tituloSerie" => "Semergen" "fecha" => "2017" "volumen" => "43" "paginaInicial" => "13" "paginaFinal" => "19" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27117909" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0195" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Low prevalence of abdominal aortic aneurysm among 65-year-old Swedish men indicates a change in the epidemiology of the disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Svensjö" 1 => "M. Björck" 2 => "M. Gürtelschmid" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.111.030379" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2011" "volumen" => "124" "paginaInicial" => "1118" "paginaFinal" => "1123" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21844079" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0200" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Update of screening for abdominal aortic aneurysm: a topical review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Svensjö" 1 => "M. Björck" 2 => "A. Wanhainen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ejvs.2014.06.034" "Revista" => array:7 [ "tituloSerie" => "Eur J Vasc Endovasc Surg" "fecha" => "2014" "volumen" => "48" "paginaInicial" => "459" "paginaFinal" => "667" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25150441" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S014067361061389X" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0205" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Analysis of risk factors for abdominal aortic aneurysm in a cohort of more than 3 million individuals" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K.C. Kent" 1 => "R.M. Zwolak" 2 => "N.N. Egorova" 3 => "T.S. Riles" 4 => "A. Manganaro" 5 => "A.J. Moskowitz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jvs.2010.05.090" "Revista" => array:7 [ "tituloSerie" => "J Vasc Surg" "fecha" => "2010" "volumen" => "52" "paginaInicial" => "539" "paginaFinal" => "548" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20630687" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0302283813013080" "estado" => "S300" "issn" => "03022838" ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0210" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of abdominal aortic aneurysm and large infrarenal aorta in patients with acute coronary syndrome and proven coronary stenosis: a prospective monocenter study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Long" 1 => "H.T. Bui" 2 => "C. Barbe" 3 => "A.H. Henni" 4 => "J. Journet" 5 => "D. Metz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.avsg.2009.12.010" "Revista" => array:6 [ "tituloSerie" => "Ann Vasc Surg" "fecha" => "2010" "volumen" => "24" "paginaInicial" => "602" "paginaFinal" => "608" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20371161" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0215" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Screening del aneurisma de aorta abdominal mediante ecocardiografía transtorácica" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D.I. Gentille-Lorente" 1 => "T. Salvadó–Usach" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.recesp.2010.11.009" "Revista" => array:7 [ "tituloSerie" => "Rev Esp Cardiol" "fecha" => "2011" "volumen" => "64" "paginaInicial" => "395" "paginaFinal" => "400" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21435771" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0302283814003960" "estado" => "S300" "issn" => "03022838" ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0220" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Utilidad de la ecografía portátil en el cribado del aneurisma de aorta abdominal y de la ateromatosis de aorta abdominal" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Sisó-Almirall" 1 => "R. Gilabert Solé" 2 => "C. Bru Saumell" 3 => "B. Kostov" 4 => "M. Mas Heredia" 5 => "L. González-de Paz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clín" "fecha" => "2013" "volumen" => "141" "paginaInicial" => "417" "paginaFinal" => "422" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0225" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surveillance strategies according to the rate of growth of small abdominal aortic aneurysms" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S.A. Badger" 1 => "C. Jones" 2 => "J. McClements" 3 => "L.L. Lau" 4 => "I.S. Young" 5 => "C.C. 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Greenhalgh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMcp012641" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2003" "volumen" => "348" "paginaInicial" => "1895" "paginaFinal" => "1901" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12736283" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0235" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Final 12-year follow-up of surgery versus surveillance in the UK Small Aneurysm Trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.T. Powell" 1 => "L.C. Brown" 2 => "J.F. Forbes" 3 => "F.G. Fowkes" 4 => "R.M. Greenhalgh" 5 => "C.V. 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Umemoto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jvs.2010.02.283" "Revista" => array:6 [ "tituloSerie" => "J Vasc Surg" "fecha" => "2010" "volumen" => "52" "paginaInicial" => "1103" "paginaFinal" => "1108" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20541347" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0245" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Screening for abdominal aortic aneurysm: U.S. Preventive Services Task Force recommendation statement" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "on behalf of the U.S Preventive Services Task Force" "etal" => false "autores" => array:2 [ 0 => "L. 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Sicard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jvs.2009.07.001" "Revista" => array:6 [ "tituloSerie" => "J Vasc Surg" "fecha" => "2009" "volumen" => "50" "paginaInicial" => "880" "paginaFinal" => "896" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19786241" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0255" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fast track echo of abdominal aortic aneurysm using a real pocket-ultrasound device at bedside" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Dijos" 1 => "Y. Pucheux" 2 => "M. Lafitte" 3 => "P. Reant" 4 => "A. Prevot" 5 => "A. 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Abdominal aortic aneurysm. Prevalence and associated risk factors in a population of patients hospitalised in Internal Medicine

Aneurisma de aorta abdominal. Prevalencia y factores de riesgo asociados en una población de pacientes ingresados en Medicina Interna

S.L. Belloch García

Servicio de Medicina Interna, Hospital Universitario de La Ribera, Alzira (Valencia), Spain

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Background</span><p id="par0005" class="elsevierStylePara elsevierViewall">Abdominal aortic aneurysm &#40;AAA&#41; is a potentially severe condition that is defined by segmental dilation of the abdominal aorta with a diameter &#8805;30<span class="elsevierStyleHsp" style=""></span>mm&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Age&#44; the male sex&#44; a personal history of atherosclerotic disease&#44; tobacco use&#44; hypertension&#44; obesity&#44; dyslipidemia&#44; coronary artery disease&#44; atherosclerosis and a family history of AAA are risk factors associated with the presence of this condition&#46;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">2&#8211;4</span></a> Tobacco use is the most important modifiable risk factor&#44;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">4</span></a> and the risk of AAA is 4<span class="elsevierStyleHsp" style=""></span>times greater in men than in women&#46; In men&#44; AAA usually starts at 50 years of age&#44; while in women&#44; the disease starts at 60&#8211;70 years of age&#44; with the incidence increasing significantly with each decade&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">5</span></a> Four studies conducted between 1988 and 1999 showed a prevalence of AAA of 4&#8211;7&#46;2&#37; in men older than 65 years&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">6&#8211;9</span></a> Studies in Spain have estimated a prevalence of AAA of 2&#46;6&#8211;4&#46;7&#37; in the general population of men older than 65 years&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">10&#8211;12</span></a> Since 2000&#44; several studies have detected a reduction in the prevalence of the disease of up to 2&#46;3&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">13&#44;14</span></a> This tendency is probably the result of a change in risk factors&#44; particularly tobacco use&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">15</span></a> In selected populations&#44; however&#44; this prevalence remains higher&#46; In a study with patients hospitalized for acute coronary syndrome and with coronary lesions of at least 50&#37;&#44; the prevalence was 6&#46;6&#37; for those older than 50 years&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">16</span></a> In Spain&#44; the rate is 5&#46;1&#37; for patients &#40;regardless of sex&#41; who underwent an echocardiogram for any reason<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">17</span></a> and 5&#46;88&#37; for primary care populations with a history of arterial hypertension or tobacco use&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">18</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The natural history of AAA is characterized by progressive expansion of the aneurysm&#44; with an estimated growth rate of 1&#8211;6<span class="elsevierStyleHsp" style=""></span>mm&#47;year&#44;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">19</span></a> although this can vary&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">20</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Rupture usually entails a mortality rate greater than 60&#8211;70&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">1</span></a> For aneurysms smaller than 5&#46;5<span class="elsevierStyleHsp" style=""></span>cm&#44; the annual risk of rupture is &#60;1&#37;&#46; However&#44; this risk increases starting at 5&#46;5<span class="elsevierStyleHsp" style=""></span>cm&#44; reaching 32&#46;5&#37; when the size of the aneurysm is &#8805;7<span class="elsevierStyleHsp" style=""></span>cm&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">21</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">During the growth phase&#44; AAA can be suspected when faced with the presence of a pulsatile abdominal mass&#44; but the sensitivity of the physical examination is poor&#46; The initial diagnostic technique for AAA is ultrasonography&#44; with a sensitivity of 95&#37; and specificity of 100&#37;&#46; CT is employed for the preoperative and postoperative assessment&#46; The dismal prognosis of a torn AAA &#40;mortality of 60&#8211;70&#37;&#41; is in sharp contrast to the excellent survival rate &#40;&#62;95&#37;&#41; after elective surgery of an undamaged aneurysm&#46; These data&#44; along with the silent course of AAAs and the possibility of a simple diagnosis through ultrasonography&#44; led to the consideration of screening for high-risk populations &#40;such as individuals older than 65 years&#44; smokers and those with a family history of AAAs&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">1</span></a> Several studies have demonstrated the benefit of AAA screening through ultrasonography&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">6&#8211;9</span></a> A meta-analysis concluded that implementing screening in men older than 65 years was associated with a 45&#37; reduction in AAA-associated mortality and with a 2&#37; reduction in overall mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">22</span></a> A number of countries have implemented AAA screening programs&#46; These programs are generally directed at men older than 65 years and especially those who are or have been smokers and who have a family history of AAA&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">23&#44;24</span></a> In the absence of a population AAA screening plan&#44; opportunistic screening can be a good alternative&#44; as is ultrasonography for other reasons and measuring the aneurysm during the implementation of an echocardiogram&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">1&#44;16&#44;17</span></a> Performing clinical ultrasonography &#40;ultrasound examination performed by the physician who is directly responsible for the patient&#41; during hospitalization can also be a good opportunity for performing a AAA screening&#46; The agreement between the AAA diagnosis using clinical ultrasonography and conventional ultrasonography is 100&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">10&#44;18&#44;25</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">We have found no published studies on the prevalence of AAA in patients hospitalized for general medical diseases&#46; However&#44; we did find publications on the prevalence of patients hospitalized for heart disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">16&#44;25</span></a> In Spain&#44; the published studies cover nonhospitalized populations&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">10&#8211;12&#44;17</span></a> Patients who are admitted to the internal medicine departments are at risk of having an AAA&#46; It is therefore important to determine its prevalence in this setting&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Moreover&#44; understanding the risk factors associated with the presence of AAA in this setting can facilitate patient selection for performing an ultrasound&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">In the field of internal medicine&#44; the incorporation of clinical ultrasonography has represented a technological breakthrough&#44; which was made possible thanks to the development of increasingly smaller and less expensive portable equipment&#46; During the hospitalization of a patient with a risk of AAA&#44; clinical ultrasonography can facilitate the early diagnosis without overloading the radiology departments&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">25</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Hypothesis and objectives</span><p id="par0045" class="elsevierStylePara elsevierViewall">Performing an abdominal ultrasound on patients older than 50 years hospitalized in an internal medicine department helps diagnose patients with asymptomatic AAA&#46;</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Primary objectives</span><p id="par0050" class="elsevierStylePara elsevierViewall">To understand the prevalence of AAA&#44; using clinical ultrasonography&#44; in the population of patients older than 50 years hospitalized in internal medicine&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">To understand the risk factors associated with the presence of AAA&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Secondary objective</span><p id="par0060" class="elsevierStylePara elsevierViewall">To determine the positive predictive value of clinical ultrasonography in detecting AAA in this population&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Design</span><p id="par0065" class="elsevierStylePara elsevierViewall">Observational&#44; cross-sectional&#44; single-center study&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Population</span><p id="par0070" class="elsevierStylePara elsevierViewall">The patients were consecutively included and randomly assigned to a physician&#46; These patients were older than 50 years and hospitalized in the Department of Internal Medicine of Hospital de La Ribera&#46; This department&#44; which has a marked hospitalist character&#44; admits all patients with medical disease for any cause&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Exclusion criteria&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0080" class="elsevierStylePara elsevierViewall">Patients already diagnosed with AAA</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0085" class="elsevierStylePara elsevierViewall">Patients for whom the current hospitalization is the result of the diagnosis of AAA&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">-</span><p id="par0090" class="elsevierStylePara elsevierViewall">Patients with stage 7 dementia on the Global Deterioration Scale&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">-</span><p id="par0095" class="elsevierStylePara elsevierViewall">Patients with active neoplasia&#46;</p></li></ul></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Sample size calculation</span><p id="par0100" class="elsevierStylePara elsevierViewall">To calculate the sample size&#44; we considered an expected AAA prevalence of 6&#37; based on the prevalence observed in other studies in specific populations&#46; Along with a 95&#37; confidence level and a precision of 3&#37;&#44; we estimated a sample size of 241 patients&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Intervention</span><p id="par0105" class="elsevierStylePara elsevierViewall">A clinical ultrasound was performed of the abdominal aorta&#44; and the aorta&#39;s diameter was measured&#46; In the positive cases&#44; conventional ultrasonography or CT was performed to confirm the diagnosis&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The ultrasound was performed at the point-of-care by a medical internist with training in clinical ultrasonography and with a portable ultrasound &#40;EDAN model DUS 60&#41; with a 3&#46;5-mHz convex probe&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Variables</span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Dependent variable</span><p id="par0115" class="elsevierStylePara elsevierViewall">The dependent variable was the presence or absence of AAA&#44; based on whether the diameter of the aorta reaches or fails to reach 3<span class="elsevierStyleHsp" style=""></span>cm&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Independent variables extracted from the medical history</span><p id="par0120" class="elsevierStylePara elsevierViewall">Age&#44; sex&#44; history of arterial hypertension&#44; dyslipidemia&#44; diabetes&#44; obesity&#44; tobacco use&#44; ischemic heart disease&#44; stroke or intermittent claudication and a first-degree family history of AAA or of early-onset ischemic heart disease&#46; We also included creatinine clearance prior to admission &#40;MDRD-4&#41;&#46; During the hospitalization&#44; we measured the ankle brachial index &#40;ABI&#41;&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Statistical analysis</span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Descriptive analysis</span><p id="par0125" class="elsevierStylePara elsevierViewall">The quantitative variables are listed with the measures of central tendency &#40;mean&#41; and of dispersion &#40;standard deviation&#44; interquartile range&#41;&#46; The qualitative variables are listed with absolute and relative frequencies expressed in percentages&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Bivariate analysis</span><p id="par0130" class="elsevierStylePara elsevierViewall">The various independent variables were related to the presence or absence of AAA&#46;<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">-</span><p id="par0135" class="elsevierStylePara elsevierViewall">The quantitative variables were compared regarding the presence or absence of AAA with Student&#39;s <span class="elsevierStyleItalic">t</span>-test or its equivalent nonparametric Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">-</span><p id="par0140" class="elsevierStylePara elsevierViewall">The categorical variables were compared with chi-squared tests or Fisher&#39;s exact test&#46;</p></li></ul></p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Multivariate analysis</span><p id="par0145" class="elsevierStylePara elsevierViewall">We determined the independent relationship of the explanatory variables with AAA&#44; using a logistic regression model&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">The analysis was performed using the SPSS statistical package&#46;</p></span></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Ethical aspects</span><p id="par0155" class="elsevierStylePara elsevierViewall">The research project was approved by the Research Committee of Hospital de La Ribera&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Informed consent was obtained from all patients for their inclusion in the project&#46;</p></span></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Results</span><p id="par0165" class="elsevierStylePara elsevierViewall">Patient selection occurred between October 2016 and June 2017&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Of the patients who met the inclusion criteria&#44; 2 did not give their consent&#44; and the abdominal aorta could not be properly visualized in 3 patients&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">A total of 241 patients were included&#44; 7 of whom were diagnosed with previously unknown AAA&#44; which represents 2&#46;9&#37; &#40;95&#37; CI 0&#46;8&#8211;5&#37;&#41;&#46; The diagnosis was confirmed by CT or ultrasonography performed by the Department of Radiology &#40;positive predictive value&#44; 100&#37;&#41;&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">The distribution of the study variables is shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0185" class="elsevierStylePara elsevierViewall">All cases were men with a current or past history of tobacco use and an age of 65 years or older &#40;the prevalence in the patient subgroup older than 65 years was 3&#46;9&#37;&#41;&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">In the bivariate analysis&#44; the relevant associations were being male &#40;OR&#44; 9&#46;39&#41;&#44; present or past tobacco use &#40;OR&#44; 13&#46;08&#41;&#44; a history of ischemic heart disease &#40;OR&#44; 5&#46;6&#59; 95&#37; CI 1&#46;21&#8211;25&#46;91&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41; and the presence of an ABI<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;9 &#40;OR&#44; 12&#46;50&#59; 95&#37; CI 2&#46;34&#8211;66&#46;77&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46; In the case of sex and tobacco use&#44; their contingency tables contain a box with the value of zero&#46; Their odds ratio was therefore calculated by approximation&#46; In these cases&#44; the confidence interval was not calculable&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">We performed a multivariate analysis using the logistic regression method and included as independent variables the history of ischemic heart disease and the presence of an ABI<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;9&#46; We excluded the variables sex and tobacco use to exclude incongruous estimates&#44; given that the 2 variables discriminated perfectly the 2 categories of the dependent variable &#40;all cases with AAA were men with a history of tobacco use&#41;&#46; The variable independently associated with the presence of AAA was an ABI<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;9 &#40;OR&#44; 10&#46;758&#59; 95&#37; CI 1&#46;968&#8211;58&#46;815&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;006&#41;&#46;</p></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Discussion</span><p id="par0200" class="elsevierStylePara elsevierViewall">Our series found 7 cases &#40;2&#46;9&#37;&#41; of previously undiagnosed AAA&#59; however&#44; we cannot compare this result with other studies because we could not find studies with populations similar to ours&#46; We can say&#44; however&#44; that the prevalence is in the lower range according to that estimated in other series&#44; even if we restrict the prevalence to those older than 65 years&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">6&#8211;12&#44;16&#44;17</span></a> This is consistent with the reduction in the incidence rate referred to in other articles&#44; which is possibly due to a reduction in tobacco consumption&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">13&#44;14</span></a></p><p id="par0205" class="elsevierStylePara elsevierViewall">In terms of sex&#44; all cases of AAA involved men&#46; This association is widely validated in the literature&#44;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">2&#8211;5&#44;17</span></a> indicating a low incidence among women&#44; which is why they are not included in population screening programs&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">14&#44;23</span></a></p><p id="par0210" class="elsevierStylePara elsevierViewall">Age is a known risk factor of AAA&#46;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">2&#8211;4&#44;17</span></a> Although age showed no correlation with the presence of AAA in the statistical analysis&#44; all cases involved patients older than 65 years&#44; falling within the age range proposed for screening programs&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">14&#44;23</span></a></p><p id="par0215" class="elsevierStylePara elsevierViewall">The association with tobacco use is another strongly associated factor&#44;<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">2&#8211;4&#44;11&#44;17</span></a> as was observed in our series and having the highest OR value&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">Arteriosclerosis&#44; established in the form of ischemic heart disease or peripheral vascular insufficiency&#44; was also related to AAA&#46; The association with ischemic heart disease<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">3&#44;15</span></a> is of special relevance when the prevalence of AAA reaches 6&#46;6&#37; in patients with acute coronary syndrome&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">16</span></a> Lastly&#44; the relationship with an ABI<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;9 has also been reported&#44;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">10&#44;16</span></a> a finding we were able to observe&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">A family history of AAA is another known factor<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">2&#44;3</span></a>&#59; however&#44; we found no association with this factor due to the small number of patients with this antecedent&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">Unlike other series&#44; we found no association with other factors such as diabetes&#44;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">10&#44;11</span></a><span class="elsevierStyleSup">&#46;</span><a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">17</span></a> dyslipidemia&#44;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">3&#44;10&#44;11</span></a> obesity<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">3</span></a> and hypertension&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">3&#44;10</span></a></p><p id="par0235" class="elsevierStylePara elsevierViewall">Other studied factors &#40;stroke&#44;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">3&#44;11&#44;17</span></a> renal function&#44;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">3&#44;11&#44;17</span></a> and a family history of early-onset cardiovascular disease&#41; that were not known to be associated with AAA were also not included in the analysis&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">In the multivariate analysis&#44; we did not include sex or a history of tobacco use due to the fact that they perfectly discriminated the presence of AAA&#46; We did include the history of ischemic heart disease and the presence of an ABI<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;9&#44; the latter of which was shown to be independently related&#46; This association has also been found in other series&#44;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">11</span></a> with a AAA prevalence rate of 9&#37; in patients with ABI<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#46;9&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">26</span></a></p><p id="par0245" class="elsevierStylePara elsevierViewall">Given the reliability for the diagnosis of AAA with clinical ultrasonography using portable equipment&#44;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">10&#44;18&#44;25</span></a> we decided to perform confirmation ultrasonography only in cases in which AAA was observed in the clinical ultrasonography&#46; Although this could detract value by not being able to calculate the negative predictive value&#44; the positive predictive value was 100&#37;&#46;</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Conclusions</span><p id="par0250" class="elsevierStylePara elsevierViewall">For patients older than 50 years hospitalized in our Department of Internal Medicine&#44; there was a 2&#46;9&#37; prevalence of previously undiagnosed AAA&#46;</p><p id="par0255" class="elsevierStylePara elsevierViewall">The data from this study lead us to recommend AAA screening for male patients older than 50 years hospitalized in internal medicine&#44; with a history of tobacco use and an ABI<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;9&#46;</p><p id="par0260" class="elsevierStylePara elsevierViewall">The incorporation of clinical ultrasonography can enable the implementation of this screening reliably&#44; inexpensively and without overloading radiology departments&#46;</p></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Funding</span><p id="par0265" class="elsevierStylePara elsevierViewall">This project was partially funded by the 2016 Research Grant of the Valencian Internal Medicine Society&#46;</p></span><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0170">Conflicts of interest</span><p id="par0270" class="elsevierStylePara elsevierViewall">The author declares that he has no conflicts of interest&#46;</p></span></span>"
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                  "titulo" => "Primary objectives"
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                1 => array:2 [
                  "identificador" => "sec0025"
                  "titulo" => "Secondary objective"
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            ]
            1 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Design"
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            2 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Population"
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            3 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Sample size calculation"
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            4 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Intervention"
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            5 => array:3 [
              "identificador" => "sec0050"
              "titulo" => "Variables"
              "secciones" => array:2 [
                0 => array:2 [
                  "identificador" => "sec0055"
                  "titulo" => "Dependent variable"
                ]
                1 => array:2 [
                  "identificador" => "sec0060"
                  "titulo" => "Independent variables extracted from the medical history"
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "sec0065"
              "titulo" => "Statistical analysis"
              "secciones" => array:3 [
                0 => array:2 [
                  "identificador" => "sec0070"
                  "titulo" => "Descriptive analysis"
                ]
                1 => array:2 [
                  "identificador" => "sec0075"
                  "titulo" => "Bivariate analysis"
                ]
                2 => array:2 [
                  "identificador" => "sec0080"
                  "titulo" => "Multivariate analysis"
                ]
              ]
            ]
            7 => array:2 [
              "identificador" => "sec0085"
              "titulo" => "Ethical aspects"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0090"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0095"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0100"
          "titulo" => "Conclusions"
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        9 => array:2 [
          "identificador" => "sec0105"
          "titulo" => "Funding"
        ]
        10 => array:2 [
          "identificador" => "sec0110"
          "titulo" => "Conflicts of interest"
        ]
        11 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2018-02-21"
    "fechaAceptado" => "2018-04-17"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1054235"
          "palabras" => array:5 [
            0 => "Abdominal aortic aneurysm"
            1 => "Prevalence"
            2 => "Risk factors"
            3 => "Internal Medicine"
            4 => "Clinical ultrasonography"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1054236"
          "palabras" => array:5 [
            0 => "Aneurisma de aorta abdominal"
            1 => "Prevalencia"
            2 => "Factores de riesgo"
            3 => "Medicina Interna"
            4 => "Ecograf&#237;a cl&#237;nica"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To determine the prevalence of previously undiagnosed abdominal aortic aneurysm &#40;AAA&#41; in patients hospitalised in a department of internal medicine&#44; as well as the associated risk factors&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Patients and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">An observational&#44; cross-sectional&#44; single-center&#44; randomized study was conducted on 241 patients hospitalised in Internal Medicine&#46; The patients were older than 50 years&#44; had no previous diagnosis of AAA and underwent clinical ultrasonography&#46; The dependent variable was the presence or absence of an aneurysm&#46; The independent variables were age&#44; sex&#44; cardiovascular risk factors&#44; cardiovascular disease&#44; renal function&#44; ankle brachial index &#40;ABI&#41;&#44; family history &#40;first degree&#41; of AAA or of early ischemic heart disease&#46; A bivariate and multivariate analysis was conducted in the statistical analysis&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The prevalence of AAA was 2&#46;9&#37; &#40;95&#37; CI&#58; 0&#46;8&#8211;5&#41;&#46; The cases were confirmed through ultrasonography or computed tomography by the Department of Radiology&#46; All patients were men with a history of smoking and with an age<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>65 years&#46; The bivariate analysis found an association between being male &#40;OR&#44; 9&#46;39&#41;&#44; smoking &#40;OR&#44; 13&#46;08&#41;&#44; ischemic heart disease &#40;OR&#44; 5&#46;6&#59; 95&#37; CI&#58; 1&#46;21&#8211;25&#46;91&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41; and ABI<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;9 &#40;OR&#44; 12&#46;50&#59; 95&#37; CI&#58; 2&#46;34&#8211;66&#46;77&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46; In the multivariate analysis&#44; the independently associated variable was an ABI<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;9 &#40;OR&#44; 10&#46;758&#59; 95&#37; CI&#58; 1&#46;968&#8211;58&#46;815&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;006&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The prevalence of undiagnosed AAA in patients older than 50 years hospitalised in internal medicine was 2&#46;9&#37;&#46; The data lead us to recommend AAA screening for this population of male patients with a history of smoking and an ABI<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;9&#46; Clinical ultrasonography enables this screening in a reliable manner&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objectives"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Patients and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Determinar la prevalencia de aneurisma de aorta abdominal &#40;AAA&#41;&#44; no diagnosticado previamente&#44; en pacientes ingresados en un Servicio de Medicina Interna&#44; as&#237; como los factores de riesgo asociados&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Pacientes y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional&#44; transversal&#44; unic&#233;ntrico&#44; aleatorizado de 241 pacientes ingresados en Medicina Interna&#44; mayores de 50 a&#241;os&#44; sin diagn&#243;stico previo de AAA&#46; Se practic&#243; una ecograf&#237;a cl&#237;nica&#46; La variable dependiente fue la presencia o no de aneurisma&#46; Las variables independientes fueron edad&#44; sexo&#44; factores de riesgo cardiovascular&#44; enfermedad cardiovascular&#44; funci&#243;n renal&#44; &#237;ndice tobillo-brazo &#40;ITB&#41;&#44; antecedente familiar de primer grado de AAA o de cardiopat&#237;a isqu&#233;mica precoz&#46; Se realiz&#243; un an&#225;lisis bivariante y multivariante&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La prevalencia del AAA fue del 2&#44;9&#37; &#40;IC 95&#37;&#58; 0&#44;8-5&#41;&#46; Los casos fueron confirmados mediante ecograf&#237;a o TAC por el Servicio de Radiolog&#237;a&#46; Todos fueron varones con antecedente de tabaquismo y con edad&#160;&#8805;&#160;65&#160;a&#241;os&#46; En el an&#225;lisis bivariante se asociaron ser var&#243;n &#40;OR&#160;&#61;&#160;9&#44;39&#41;&#44; el tabaquismo &#40;OR&#160;&#61;&#160;13&#44;08&#41;&#44; cardiopat&#237;a isqu&#233;mica &#40;OR&#160;&#61;&#160;5&#44;6&#59; IC&#160;95&#37;&#58; 1&#44;21-25&#44;91&#59; p&#160;&#60;&#160;0&#44;05&#41; e ITB inferior a 0&#44;9 &#40;OR&#160;&#61;&#160;12&#44;50&#59; IC&#160;95&#37;&#160;&#61;&#160;2&#44;34-66&#44;77&#59; p&#160;&#60;&#160;0&#44;05&#41;&#46; En el an&#225;lisis multivariante la variable asociada independientemente fue un ITB&#160;&#60;&#160;0&#44;9 &#40;OR&#58; 10&#44;758&#59; IC&#160;95&#37;&#58; 1&#44;968-58&#44;815&#59; p&#160;&#61;&#160;0&#44;006&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La prevalencia de AAA no diagnosticado en pacientes mayores de 50 a&#241;os ingresados en Medicina Interna fue del 2&#44;9&#37;&#46; Los datos llevar&#237;an a recomendar el cribado de AAA en esta poblaci&#243;n de pacientes varones&#44; con antecedente de tabaquismo y con un ITB inferior a 0&#44;9&#46; La ecograf&#237;a cl&#237;nica posibilitar&#237;a este cribado de forma fiable&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivos"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Pacientes y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Belloch Garc&#237;a S&#46; Aneurisma de aorta abdominal&#46; Prevalencia y factores de riesgo asociados en una poblaci&#243;n de pacientes ingresados en Medicina Interna&#46; Rev Clin Esp&#46; 2018&#59;218&#58;455&#8211;460&#46;</p>"
      ]
    ]
    "multimedia" => array:1 [
      0 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
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        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Without AAA <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">With AAA <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Patients</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">241&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">234&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age in years</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">71&#46;6 &#40;SD 10&#46;92&#59; range&#44; 50&#8211;93&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">71&#46;54 &#40;SD&#44; 10&#46;52&#59; range&#44; 50&#8211;93&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">72&#46;4 &#40;SD 5&#46;7&#59; range 65&#8211;79&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;991&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age &#8805;65 years n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">178 &#40;73&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">171 &#40;73&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;195&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Sex n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">151 &#40;62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">144 &#40;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;048&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">90 &#40;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">90 &#40;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Arterial hypertension</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">166 &#40;68&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">161 &#40;68&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;71&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">81 &#40;33&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78 &#40;33&#46;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;42&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;690&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Dyslipidemia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">94 &#40;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">89 &#40;38&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;71&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;113&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Obesity</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80 &#40;33&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">78 &#40;33&#46;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;28&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Tobacco use &#40;past or present&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">132 &#40;54&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">125 &#40;53&#46;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#46;017&nbsp;\t\t\t\t\t\t\n
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            0 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2014 ESC Guidelines on the diagnosis and treatment of aortic diseases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Eerbel"
                            1 => "V&#46; Aboyans"
                            2 => "C&#46; Boileau"
                            3 => "E&#46; Bossone"
                            4 => "R&#46; Di Bartolomeo"
                            5 => "H&#46; Eggebrecht"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehu281"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2014"
                        "volumen" => "35"
                        "paginaInicial" => "2873"
                        "paginaFinal" => "2926"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25173340"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Abdominal aortic aneurysm&#58; pathogenesis and implications for management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Golledge"
                            1 => "J&#46; Muller"
                            2 => "A&#46; Daugherty"
                            3 => "P&#46; Norman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/01.ATV.0000245819.32762.cb"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arterioscler Thromb Vasc Biol"
                        "fecha" => "2006"
                        "volumen" => "26"
                        "paginaInicial" => "2605"
                        "paginaFinal" => "2613"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16973970"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The aneurysm detection and management study screening program&#58; validation cohort and final results &#40;Aneurysm Detection and Management Veterans Affairs Cooperative Study Investigators&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
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                            0 => "F&#46;A&#46; Lederle"
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                            2 => "S&#46;E&#46; Wilson"
                            3 => "E&#46;P&#46; Chute"
                            4 => "R&#46;J&#46; Hye"
                            5 => "M&#46;S&#46; Makaroun"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Arch Intern Med"
                        "fecha" => "2000"
                        "volumen" => "160"
                        "paginaInicial" => "1425"
                        "paginaFinal" => "1430"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10826454"
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              "identificador" => "bib0150"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "Risk factors for abdominal aortic aneurysms&#58; a 7-year prospective study&#58; the Troms&#248; Study&#44; 1994&#8211;2001"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
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                        ]
                      ]
                    ]
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                        "fecha" => "2009"
                        "volumen" => "119"
                        "paginaInicial" => "2202"
                        "paginaFinal" => "2208"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19364978"
                            "web" => "Medline"
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              "identificador" => "bib0155"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Increasing prevalence of abdominal aortic aneurysms&#58; a necropsy study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46; Bengtsson"
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                            2 => "N&#46;H&#46; Sternby"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Surg"
                        "fecha" => "1992"
                        "volumen" => "158"
                        "paginaInicial" => "19"
                        "paginaFinal" => "23"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1348634"
                            "web" => "Medline"
                          ]
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                          "etal" => true
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                            3 => "L&#46;G&#46; Kim"
                            4 => "T&#46;M&#46; Marteau"
                            5 => "R&#46;A&#46; Scott"
                          ]
                        ]
                      ]
                    ]
                  ]
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                        "tituloSerie" => "Lancet"
                        "fecha" => "2002"
                        "volumen" => "360"
                        "paginaInicial" => "1531e9"
                      ]
                    ]
                  ]
                ]
              ]
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                      "titulo" => "Influence of screening on the incidence of ruptured abdominal aortic aneurysm&#58; 5-year results of a randomized controlled study"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
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                            3 => "D&#46;N&#46; Kay"
                          ]
                        ]
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                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Surg"
                        "fecha" => "1995"
                        "volumen" => "82"
                        "paginaInicial" => "1066"
                        "paginaFinal" => "1070"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7648155"
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                        "tituloSerie" => "BMJ"
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                        "volumen" => "329"
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                          ]
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                ]
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Barba"
                            1 => "M&#46; Vega de C&#233;niga"
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                            4 => "B&#46; Viviens"
                            5 => "R&#46; G&#243;mez"
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                      "titulo" => "Despistaje de aneurisma de aorta abdomnial en Atenci&#243;n Primaria"
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                          "etal" => false
                          "autores" => array:6 [
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                            2 => "C&#46; Berm&#250;dez"
                            3 => "R&#46; Garc&#237;a"
                            4 => "E&#46; Ruiz"
                            5 => "J&#46; Urbano"
                          ]
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                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.semerg.2016.03.003"
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                        "tituloSerie" => "Semergen"
                        "fecha" => "2017"
                        "volumen" => "43"
                        "paginaInicial" => "13"
                        "paginaFinal" => "19"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27117909"
                            "web" => "Medline"
                          ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Low prevalence of abdominal aortic aneurysm among 65-year-old Swedish men indicates a change in the epidemiology of the disease"
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                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Svensj&#246;"
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                            2 => "M&#46; G&#252;rtelschmid"
                          ]
                        ]
                      ]
                    ]
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                      "doi" => "10.1161/CIRCULATIONAHA.111.030379"
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                        "tituloSerie" => "Circulation"
                        "fecha" => "2011"
                        "volumen" => "124"
                        "paginaInicial" => "1118"
                        "paginaFinal" => "1123"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21844079"
                            "web" => "Medline"
                          ]
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                ]
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              "identificador" => "bib0200"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Update of screening for abdominal aortic aneurysm&#58; a topical review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Svensj&#246;"
                            1 => "M&#46; Bj&#246;rck"
                            2 => "A&#46; Wanhainen"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1016/j.ejvs.2014.06.034"
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                        "tituloSerie" => "Eur J Vasc Endovasc Surg"
                        "fecha" => "2014"
                        "volumen" => "48"
                        "paginaInicial" => "459"
                        "paginaFinal" => "667"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25150441"
                            "web" => "Medline"
                          ]
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                          "issn" => "01406736"
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                  ]
                ]
              ]
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              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Analysis of risk factors for abdominal aortic aneurysm in a cohort of more than 3 million individuals"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46;C&#46; Kent"
                            1 => "R&#46;M&#46; Zwolak"
                            2 => "N&#46;N&#46; Egorova"
                            3 => "T&#46;S&#46; Riles"
                            4 => "A&#46; Manganaro"
                            5 => "A&#46;J&#46; Moskowitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jvs.2010.05.090"
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                        "tituloSerie" => "J Vasc Surg"
                        "fecha" => "2010"
                        "volumen" => "52"
                        "paginaInicial" => "539"
                        "paginaFinal" => "548"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20630687"
                            "web" => "Medline"
                          ]
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                          "pii" => "S0302283813013080"
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                          "issn" => "03022838"
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                  ]
                ]
              ]
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            15 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "16"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of abdominal aortic aneurysm and large infrarenal aorta in patients with acute coronary syndrome and proven coronary stenosis&#58; a prospective monocenter study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Long"
                            1 => "H&#46;T&#46; Bui"
                            2 => "C&#46; Barbe"
                            3 => "A&#46;H&#46; Henni"
                            4 => "J&#46; Journet"
                            5 => "D&#46; Metz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.avsg.2009.12.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Vasc Surg"
                        "fecha" => "2010"
                        "volumen" => "24"
                        "paginaInicial" => "602"
                        "paginaFinal" => "608"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20371161"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Screening del aneurisma de aorta abdominal mediante ecocardiograf&#237;a transtor&#225;cica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;I&#46; Gentille-Lorente"
                            1 => "T&#46; Salvad&#243;&#8211;Usach"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1016/j.recesp.2010.11.009"
                      "Revista" => array:7 [
                        "tituloSerie" => "Rev Esp Cardiol"
                        "fecha" => "2011"
                        "volumen" => "64"
                        "paginaInicial" => "395"
                        "paginaFinal" => "400"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21435771"
                            "web" => "Medline"
                          ]
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                    0 => array:2 [
                      "titulo" => "Utilidad de la ecograf&#237;a port&#225;til en el cribado del aneurisma de aorta abdominal y de la ateromatosis de aorta abdominal"
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                        0 => array:2 [
                          "etal" => true
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                            0 => "A&#46; Sis&#243;-Almirall"
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                            2 => "C&#46; Bru Saumell"
                            3 => "B&#46; Kostov"
                            4 => "M&#46; Mas Heredia"
                            5 => "L&#46; Gonz&#225;lez-de Paz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Cl&#237;n"
                        "fecha" => "2013"
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                        "paginaInicial" => "417"
                        "paginaFinal" => "422"
                      ]
                    ]
                  ]
                ]
              ]
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            18 => array:3 [
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              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Surveillance strategies according to the rate of growth of small abdominal aortic aneurysms"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46;A&#46; Badger"
                            1 => "C&#46; Jones"
                            2 => "J&#46; McClements"
                            3 => "L&#46;L&#46; Lau"
                            4 => "I&#46;S&#46; Young"
                            5 => "C&#46;C&#46; Patterson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/1358863X11423971"
                      "Revista" => array:7 [
                        "tituloSerie" => "Vasc Med"
                        "fecha" => "2011"
                        "volumen" => "16"
                        "paginaInicial" => "415"
                        "paginaFinal" => "421"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22128040"
                            "web" => "Medline"
                          ]
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                          "pii" => "S1470204514712057"
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                          "issn" => "14702045"
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                  ]
                ]
              ]
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            19 => array:3 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Small abdominal aortic aneurysms"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;T&#46; Powell"
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                    ]
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                      "doi" => "10.1056/NEJMcp012641"
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                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2003"
                        "volumen" => "348"
                        "paginaInicial" => "1895"
                        "paginaFinal" => "1901"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12736283"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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                    0 => array:2 [
                      "titulo" => "Final 12-year follow-up of surgery versus surveillance in the UK Small Aneurysm Trial"
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                          "etal" => true
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                            3 => "F&#46;G&#46; Fowkes"
                            4 => "R&#46;M&#46; Greenhalgh"
                            5 => "C&#46;V&#46; Ruckley"
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                        ]
                      ]
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                    0 => array:2 [
                      "doi" => "10.1002/bjs.5778"
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                        "tituloSerie" => "Br J Surg"
                        "fecha" => "2007"
                        "volumen" => "94"
                        "paginaInicial" => "702"
                        "paginaFinal" => "708"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17514693"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A further meta-analysis of population-based screening for abdominal aortic aneurysm"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46; Takagi"
                            1 => "S&#46;N&#46; Goto"
                            2 => "M&#46; Matsui"
                            3 => "H&#46; Manabe"
                            4 => "T&#46; Umemoto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jvs.2010.02.283"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Vasc Surg"
                        "fecha" => "2010"
                        "volumen" => "52"
                        "paginaInicial" => "1103"
                        "paginaFinal" => "1108"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20541347"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "23"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Screening for abdominal aortic aneurysm&#58; U&#46;S&#46; Preventive Services Task Force recommendation statement"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "on behalf of the U&#46;S Preventive Services Task Force"
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                          "autores" => array:2 [
                            0 => "L&#46; Michael"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7326/M14-1204"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "2014"
                        "volumen" => "161"
                        "paginaInicial" => "281"
                        "paginaFinal" => "290"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24957320"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0250"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "SVS practice guidelines for the care of patients with an abdominal aortic aneurysm&#58; executive summary"
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                          "etal" => true
                          "autores" => array:6 [
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                            2 => "R&#46;L&#46; Dalman"
                            3 => "M&#46;S&#46; Makaroun"
                            4 => "K&#46;A&#46; Illig"
                            5 => "G&#46;A&#46; Sicard"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jvs.2009.07.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Vasc Surg"
                        "fecha" => "2009"
                        "volumen" => "50"
                        "paginaInicial" => "880"
                        "paginaFinal" => "896"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19786241"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Fast track echo of abdominal aortic aneurysm using a real pocket-ultrasound device at bedside"
                      "autores" => array:1 [
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                          "etal" => true
                          "autores" => array:6 [
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                            2 => "M&#46; Lafitte"
                            3 => "P&#46; Reant"
                            4 => "A&#46; Prevot"
                            5 => "A&#46; Mignot"
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                        ]
                      ]
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                        "tituloSerie" => "Echocardiography"
                        "fecha" => "2012"
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                        "paginaInicial" => "285"
                        "paginaFinal" => "290"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22066817"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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                      "titulo" => "Abdominal aortic aneurysm in patients affected by intermittent claudication&#58; prevalence and clinical predictors"
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                          "etal" => true
                          "autores" => array:6 [
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                            2 => "C&#46; Rengo"
                            3 => "G&#46; De Rosa"
                            4 => "L&#46; Brevetti"
                            5 => "A&#46; Sannino"
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                        "link" => array:1 [
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Article information

ISSN: 22548874
Original language: English

DOI:10.1016/j.rceng.2018.04.005

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