# Disparities in Detection and Treatment of Abdominal Aortic Aneurysm Disease

> **NIH AHRQ F32** · BETH ISRAEL DEACONESS MEDICAL CENTER · 2021 · $70,458

## Abstract

Project Summary/Abstract
 Abdominal aortic aneurysms (AAAs) are found in 2 to 8 percent of patients in developed countries and can
progress to life-threatening rupture if left untreated, with mortality rates as high as 80%. Endovascular AAA
repair (EVAR) is a less invasive alternative to traditional open repair and has become the preferred approach
to repairing intact AAAs. Increasing use of EVAR has resulted in higher rates of elective repair, lower rates of
aneurysm rupture, and lower short-term aneurysm-related mortality. Unfortunately, these improved outcomes
are not universally experienced, and disparities continue to exist in the detection, treatment, and outcomes of
AAA by age, sex, and race.
 Currently, the U.S. Preventive Services Task Force (USPSTF) recommends a one-time AAA screening
ultrasound only in men aged 65-75, despite the potential for improved outcomes from early identification in
older and female patients, and those with other risk factors. It is well known that AAA prevalence and rupture
risk are highest among the elderly, and female and black patients more frequently present with rupture and
have worse outcomes following repair. However, the underlying reasons for these differences remain poorly
understood. To address these questions, this study proposes to examine disparities in AAA screening
ultrasound usage, specialist referral, and treatment modality (EVAR versus open repair) by age, sex, and race.
 Using a 20% random sample of all Medicare beneficiaries, the specific aims of this proposal therefore are:
1) To evaluate age, sex, and race disparities in the opportunity to diagnose abdominal aortic aneurysm by
rates of imaging modality use, including abdominal CT scan, general abdominal ultrasound, and AAA
screening ultrasound, and the subsequent rates of diagnosed AAA based on diagnosis code; and 2) To
examine age, sex, and race disparities in management of abdominal aortic aneurysm disease by determining
a) the rates of referral to a specialist who performs AAA repair among patients with a new diagnosis of AAA,
also examining the volume and outcomes of the specialist/institution to whom the patient is referred, b) the
presentation at repair (intact versus ruptured), and c) the type of repair (EVAR versus open).
 In summary, this study will elucidate the underlying causes for disparities in AAA outcomes among specific
AHRQ priority populations (elderly, women, racial minorities) and identify clinical targets for improvement. To
accomplish these specific aims, this research will be conducted with direct guidance from Dr. Schermerhorn
and Dr. Landon and with focused disparities mentorship from Dr. Rodrique. This project will also involve
collaboration with the FIRST Program at Beth Israel Deaconess Medical Center and the Department of Health
Care Policy at Harvard Medical School. These groups include fellows and faculty with expertise in health
services research and statistical methods related to the use of observational d...

## Key facts

- **NIH application ID:** 10219825
- **Project number:** 5F32HS027285-02
- **Recipient organization:** BETH ISRAEL DEACONESS MEDICAL CENTER
- **Principal Investigator:** CHRISTINA MARCACCIO
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2021
- **Award amount:** $70,458
- **Award type:** 5
- **Project period:** 2020-07-08 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10219825

## Citation

> US National Institutes of Health, RePORTER application 10219825, Disparities in Detection and Treatment of Abdominal Aortic Aneurysm Disease (5F32HS027285-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10219825. Licensed CC0.

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