Many vascular surgery patients will be lost to follow-up. We aimed to determine whether socioeconomic status (SES), insurance provider, race, or comorbidities affected the appropriate surveillance of patients with a known abdominal aortic aneurysm (AAA). Patients aged >18 years evaluated in the outpatient setting from October 2009 to January 2020 for AAAs were eligible. Race, gender, insurance status or provider, zip code, comorbidities, age, date of initial presentation, initial AAA size, AAA growth, and subsequent follow-up and imaging studies were collected. Appropriate follow-up was defined by the 2009 Society for Vascular Surgery (SVS) practice management guidelines for AAA surveillance, and a metric of >80% compliance with the guidelines was set. The median household income was obtained from the U.S. Census Bureau. Data analysis was performed using SPSS (IBM Corp, Armonk, NY). The study included 140 patients (Table). Appropriate follow-up and imaging with >80% compliance with guidelines was achieved for 64% of the patients. Aneurysm growth at follow-up had occurred in 94 patients; 59 had undergone repair, 3 of which were emergent. Finally, 35% of patients were ultimately lost to follow-up, even if initially compliant. Mortality was 20%. SES, race, insurance provider, and all comorbid conditions did not significantly affect compliance with appropriate follow-up or loss to follow-up. Rigorous follow-up of patients with AAAs is indicated by the SVS guidelines. Previous studies have identified several at-risk groups for diminished follow-up in vascular pathologies. For surveillance of known AAAs, only 64% of patients achieved 80% compliance with the SVS guidelines for follow-up and 35% of patients were lost to follow-up. No single factor, including insurance provider, SES, race, or comorbidities, significantly contributed to either loss to follow-up or noncompliance with SVS guidelines. Many patients experienced AAA growth and had ultimately required intervention, warranting further study into the explanations for inappropriate/loss to follow-up. Additional education of patients and practitioners alike regarding appropriate follow-up (including improved medical record automation) has the potential to improve surveillance and should also be strongly considered.TablePatient demographicsDemographicPatients, No.Sex Male101 Female39Race White106 Black33 Hispanic0 Asian0 Other1Insurance status Yes133 No6Insurance provider Private28 Medicare101 Medicaid4SES Poor/near poor15 Lower middle class80 Middle class41 Upper middle class4Comorbidity CAD/MI72 CHF21 COPD37 CVA30 PVD31 CKD/ESRD31 DM30 Cancer47CAD, Coronary artery disease; CHF, congestive heart failure; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; CVA, cerebrovascular accident; DM, diabetes mellitus; ESRD, end-stage renal disease; MI, myocardial infarction; PVD, peripheral vascular disease; SES, socioeconomic status. Open table in a new tab