Development and validation of a risk prediction model for abdominal aortic aneurysm: a nationwide population-based cohort study

Abstract Abdominal aortic aneurysm (AAA) is characterized by irreversible localized dilatation of the abdominal aorta. It poses a significant health risk. As AAA size tends to increase over time, there is a heightened risk of rupture, resulting in a substantially high mortality rate. Although AAA sc...

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Main Authors: Hyung-jin Cho, Mi-hyeong Kim, Kyung-Jai Ko, Kang-woong Jun, Kyung-do Han, Jeong-Kye Hwang
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-11956-1
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author Hyung-jin Cho
Mi-hyeong Kim
Kyung-Jai Ko
Kang-woong Jun
Kyung-do Han
Jeong-Kye Hwang
author_facet Hyung-jin Cho
Mi-hyeong Kim
Kyung-Jai Ko
Kang-woong Jun
Kyung-do Han
Jeong-Kye Hwang
author_sort Hyung-jin Cho
collection DOAJ
description Abstract Abdominal aortic aneurysm (AAA) is characterized by irreversible localized dilatation of the abdominal aorta. It poses a significant health risk. As AAA size tends to increase over time, there is a heightened risk of rupture, resulting in a substantially high mortality rate. Although AAA screening programs targeting specific demographics are available, there is room for improvement in terms of inclusivity and cost-effectiveness. This study aimed to develop a predictive model for AAA occurrence utilizing seven years of data from the Korean National Health Insurance Service database (NHIS). This study utilized NHIS data from 2009 to 2020. A total of 4,234,415 individuals who underwent health examinations in 2009 were identified. After applying exclusion criteria, a total of 3,937,535 individuals were selected. Of them, 70% were used for model development and 30% were used for validation. The mean follow-up duration was 10.11 ± 1.29 years, during which 2,836 cases of AAA were identified among 1,181,131 (2.4%) participants in the validation cohort. The model incorporated a set of 10 variables, encompassing age, sex, obesity, smoking, drinking, diabetes (DM), hypertension (HTN), dyslipidemia, chronic kidney disease (CKD), and cardiocerebrovascular disease (CVD). Evaluation of the model’s predictive performance revealed an area under the curve (AUC) of 0.807 (95% CI: 0.80–0.81) when it was applied to the development cohort. The AUC remained high at 0.803 (95% CI: 0.79–0.81) when the model was applied to the validation cohort, indicating its effectiveness in forecasting AAA occurrence. A multivariable risk model for predicting the onset of AAA was successfully developed, showcasing an excellent performance with an AUC value of 0.807, surpassing traditional screening methods. This model has the potential to selectively identify high-risk patients from a slightly broader pool than current screening approaches. Priority should be given to proactive screening efforts targeting individuals at elevated risk for AAA, with the goal of reducing AAA-related mortality.
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spelling doaj-art-9e313263c40a49c3bbf4ebfb68ecdea62025-08-20T03:05:23ZengNature PortfolioScientific Reports2045-23222025-07-0115111010.1038/s41598-025-11956-1Development and validation of a risk prediction model for abdominal aortic aneurysm: a nationwide population-based cohort studyHyung-jin Cho0Mi-hyeong Kim1Kyung-Jai Ko2Kang-woong Jun3Kyung-do Han4Jeong-Kye Hwang5Division of Vascular and Transplant Surgery, Department of Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDivision of Vascular and Transplant Surgery, Department of Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Surgery, Kangdong Sacred Heart HospitalDivision of Vascular and Transplant Surgery, Department of Surgery, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Statistics and Actuarial Science, Soongsil UniversityDivision of Vascular and Transplant Surgery, Department of Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaAbstract Abdominal aortic aneurysm (AAA) is characterized by irreversible localized dilatation of the abdominal aorta. It poses a significant health risk. As AAA size tends to increase over time, there is a heightened risk of rupture, resulting in a substantially high mortality rate. Although AAA screening programs targeting specific demographics are available, there is room for improvement in terms of inclusivity and cost-effectiveness. This study aimed to develop a predictive model for AAA occurrence utilizing seven years of data from the Korean National Health Insurance Service database (NHIS). This study utilized NHIS data from 2009 to 2020. A total of 4,234,415 individuals who underwent health examinations in 2009 were identified. After applying exclusion criteria, a total of 3,937,535 individuals were selected. Of them, 70% were used for model development and 30% were used for validation. The mean follow-up duration was 10.11 ± 1.29 years, during which 2,836 cases of AAA were identified among 1,181,131 (2.4%) participants in the validation cohort. The model incorporated a set of 10 variables, encompassing age, sex, obesity, smoking, drinking, diabetes (DM), hypertension (HTN), dyslipidemia, chronic kidney disease (CKD), and cardiocerebrovascular disease (CVD). Evaluation of the model’s predictive performance revealed an area under the curve (AUC) of 0.807 (95% CI: 0.80–0.81) when it was applied to the development cohort. The AUC remained high at 0.803 (95% CI: 0.79–0.81) when the model was applied to the validation cohort, indicating its effectiveness in forecasting AAA occurrence. A multivariable risk model for predicting the onset of AAA was successfully developed, showcasing an excellent performance with an AUC value of 0.807, surpassing traditional screening methods. This model has the potential to selectively identify high-risk patients from a slightly broader pool than current screening approaches. Priority should be given to proactive screening efforts targeting individuals at elevated risk for AAA, with the goal of reducing AAA-related mortality.https://doi.org/10.1038/s41598-025-11956-1Aortic aneurysmAbdominalNomograms
spellingShingle Hyung-jin Cho
Mi-hyeong Kim
Kyung-Jai Ko
Kang-woong Jun
Kyung-do Han
Jeong-Kye Hwang
Development and validation of a risk prediction model for abdominal aortic aneurysm: a nationwide population-based cohort study
Scientific Reports
Aortic aneurysm
Abdominal
Nomograms
title Development and validation of a risk prediction model for abdominal aortic aneurysm: a nationwide population-based cohort study
title_full Development and validation of a risk prediction model for abdominal aortic aneurysm: a nationwide population-based cohort study
title_fullStr Development and validation of a risk prediction model for abdominal aortic aneurysm: a nationwide population-based cohort study
title_full_unstemmed Development and validation of a risk prediction model for abdominal aortic aneurysm: a nationwide population-based cohort study
title_short Development and validation of a risk prediction model for abdominal aortic aneurysm: a nationwide population-based cohort study
title_sort development and validation of a risk prediction model for abdominal aortic aneurysm a nationwide population based cohort study
topic Aortic aneurysm
Abdominal
Nomograms
url https://doi.org/10.1038/s41598-025-11956-1
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