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Meta-Analysis
. 2018 Dec 10;15(12):2805.
doi: 10.3390/ijerph15122805.

Risk Factors for Abdominal Aortic Aneurysm in Population-Based Studies: A Systematic Review and Meta-Analysis

Emma Altobelli  1   2 , Leonardo Rapacchietta  3 , Valerio F Profeta  4 , Roberto Fagnano  5
Affiliations
Meta-Analysis

Risk Factors for Abdominal Aortic Aneurysm in Population-Based Studies: A Systematic Review and Meta-Analysis

Emma Altobelli et al. Int J Environ Res Public Health. .

Abstract

Abdominal aortic aneurysm (AAA) represents an important public health problem with a prevalence between 1.3% and 12.5%. Several population-based randomized trials have evaluated ultrasound screening for AAA providing evidence of a reduction in aneurysm-related mortality in the screened population. The aim of our study was to perform a systematic review and meta-analysis of the risk factors for AAA. We conducted a systematic review of observational studies and we performed a meta-analysis that evaluated the following risk factors: gender, smoking habits, hypertension, coronary artery disease and family history of AAA. Respect to a previous a meta-analysis we added the funnel plot to examine the effect sizes estimated from individual studies as measure of their precision; sensitivity analysis to check the stability of study findings and estimate how the overall effect size would be modified by removal of one study; cumulative analysis to evaluate the trend between studies in relation to publication year. Abdominal aortic aneurysm prevalence is higher in smokers and in males. On the other hand, while diabetes is a risk factor for many cardiovascular diseases, it is not a risk factor for AAA. In addition, it is important to underline that all countries, where AAA screening was set up, had high income level and the majority belong to Western Europe (United Kingdom, Sweden, Italy, Poland, Spain and Belgium). Abdominal aortic aneurysm screening is fundamental for public health. It could avoid deaths, ruptures, and emergency surgical interventions if abdominal aortic aneurysm was diagnosed early in the population target for screening.

Keywords: abdominal aortic aneurysm; meta-analysis; observational studies; risk factors.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of search strategy.
Figure 2
Figure 2
Gender. (A) Forest plot (N1 Male; N2 Female); (B) sensitivity analysis; (C) cumulative analysis; (D) funnel plot.
Figure 3
Figure 3
Smoker. (A) Forest plot (N1 Smokers; N2 Not smokers); (B) sensitivity analysis; (C) cumulative analysis; (D) funnel plot.
Figure 4
Figure 4
Hypertension. (A) Forest plot (N1 Hypertension; N2 Not hypertension); (B) sensitivity analysis; (C) cumulative analysis; (D) funnel plot.
Figure 5
Figure 5
Diabetes. (A) Forest plot (N1 Diabetes; N2 Not Diabetes); (B) sensitivity analysis; (C) cumulative analysis; (D) funnel plot.
Figure 6
Figure 6
Coronary Artery Diseases (CAD). (A) Forest plot (N1 CAD; N2 Not CAD); (B) sensitivity analysis; (C) cumulative analysis; (D) funnel plot.
Figure 7
Figure 7
Family history of abdominal aortic aneurysm (AAA). (A) Forest plot (N1 Family history; N2 Not Family history); (B) sensitivity analysis; (C) cumulative analysis; (D) funnel plot.
See this image and copyright information in PMC

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