Literature data on the effect of smoking on AAA expansion and rupture was factored into the model.
Results: The intervention was cost-effective in all tested scenarios and sensitivity analyses. The smoking cessation intervention was cost-effective
due to a decreased need for AAA repair and decreased rupture see more rate even when disregarding the positive effects of smoking cessation on long-term survival. The incremental cost/effectiveness ratio reached the willingness-to-pay threshold value of 25,000 per life-year gained when assuming an intervention cost of >(sic)3250 or an effect of <= 1% difference in long-term smoking cessation between the intervention and nonintervention groups. Smoking cessation resulted in a relative risk reduction for elective AAA repair by 9% and for rupture by 38% over 10 years of follow-up.
Conclusions: An adequate smoking cessation intervention in patients with small AAAs identified at screening can
cost-effectively increase long-term survival and decrease the need for AAA repair. (J Vase Surg 2011;54:628-36.)”
“BACKGROUND: Aneurysm size ratio (SR), variably defined as the ratio of dome height (H) or maximal DMXAA dimension (D-max) over average parent vessel diameter (PV) diameter, has been proposed as a promising aneurysm rupture status predictor.
OBJECTIVE: To evaluate the incremental contribution of SR to retrospective rupture status determination in a large high-resolution aneurysm database.
METHODS: Measurements were performed on catheter 3D-rotational angiographic volumetric datasets for 267 aneurysms (98 ruptured). SR was computed both as H/PV (SR1) and as D-max/PV (SR2), and its discriminant performance was evaluated on the whole dataset, on aneurysm-type subsets (bifurcation [BIF] vs sidewall [SW]), and at specific aneurysm locations. Univariate and multivariate statistical analyses were performed by the use of area under the curve (AUC) of the receiver-operating characteristics.
RESULTS: Neither SR1 nor SR2 were statistically correlated to rupture status in the BIF group, where only PV (AUC =
0.61) achieved significance. All parameters were Quisqualic acid statistically significant in the combined group, but with modest performance (AUC range, 0.62-0.74). SR1 (AUC = 0.84) and SR2 (AUC = 0.78) were strong predictors in the SW group, similar to H (AUC = 0.83) and D-max (AUC = 0.77). Multivariate statistics failed to support SR as an incremental independent parameter from PV, D-max, and H.
CONCLUSION: SR provides an uneven performance that depends strongly on the BIF/SW distribution of the data and is not useful for bifurcation lesions. In the SW subset, the incremental contribution of the SR over its H or D-max individual component measurements could not be validated, suggesting prior findings of its utility to be the result of aneurysm-type selection bias.”
“Objective: We investigated whether postpartum blues was related to changes in parameters of noradrenergic and serotonergic functioning.