TY - JOUR

T1 - Comparison of risk-scoring methods in predicting the immediate outcome after elective open abdominal aneurysm surgery

AU - Tang, Tjun

AU - Walsh, S.R.

AU - Fanshawe, Thomas

AU - Seppi, V.

AU - Sadat, U.

AU - Hayes, P.D.

AU - Varty, K.

AU - Gaunt, M.E.

AU - Boyle, J.R.

PY - 2007/11

Y1 - 2007/11

N2 - Background & ObjectivesThe aim of this study was to apply three simple risk - scoring systems to prospectively collected data on all elective open Abdominal Aortic Aneurysm (AAA) operations in the Cambridge Academic Vascular Unit over a 6 - year period (January 1998 to January 2004), to compare their predictive values and to evaluate their validity with respect to prediction of mortality and post-operative complications.Methods204 patients underwent elective open infra-renal AAA repair. Data were prospectively collected and risk assessment scores were calculated for mortality and morbidity according to the Glasgow Aneurysm Score (GAS), VBHOM (Vascular Biochemistry and Haematology Outcome Models) and Estimation of Physiologic Ability and Surgical Stress (E-PASS).ResultsThe mortality rate was 6.3% (13/204) and 59% (121/204) experienced a post-operative complication (30-day outcome). For GAS, VBHOM and E-PASS the receiver operating characteristics (ROC) curve analysis for prediction of in-hospital mortality showed area under the curve (AUC) of 0.84 (95% confidence interval [CI], 0.76 to 0.92; p < 0.0001), 0.82 (95% CI, 0.68 to 0.95; p = 0.0001) and 0.92 (95% CI, 0.87 to 0.97; p < 0.0001) respectively. There were also significant correlations between post-operative complications and length of hospital stay and each of the three scores, but the correlation was substantially higher in the case of E-PASS.ConclusionsAll three scoring systems accurately predicted the risk of mortality and morbidity in patients undergoing elective open AAA repair. Among these, E-PASS seemed to be the most accurate predictor in this patient population.

AB - Background & ObjectivesThe aim of this study was to apply three simple risk - scoring systems to prospectively collected data on all elective open Abdominal Aortic Aneurysm (AAA) operations in the Cambridge Academic Vascular Unit over a 6 - year period (January 1998 to January 2004), to compare their predictive values and to evaluate their validity with respect to prediction of mortality and post-operative complications.Methods204 patients underwent elective open infra-renal AAA repair. Data were prospectively collected and risk assessment scores were calculated for mortality and morbidity according to the Glasgow Aneurysm Score (GAS), VBHOM (Vascular Biochemistry and Haematology Outcome Models) and Estimation of Physiologic Ability and Surgical Stress (E-PASS).ResultsThe mortality rate was 6.3% (13/204) and 59% (121/204) experienced a post-operative complication (30-day outcome). For GAS, VBHOM and E-PASS the receiver operating characteristics (ROC) curve analysis for prediction of in-hospital mortality showed area under the curve (AUC) of 0.84 (95% confidence interval [CI], 0.76 to 0.92; p < 0.0001), 0.82 (95% CI, 0.68 to 0.95; p = 0.0001) and 0.92 (95% CI, 0.87 to 0.97; p < 0.0001) respectively. There were also significant correlations between post-operative complications and length of hospital stay and each of the three scores, but the correlation was substantially higher in the case of E-PASS.ConclusionsAll three scoring systems accurately predicted the risk of mortality and morbidity in patients undergoing elective open AAA repair. Among these, E-PASS seemed to be the most accurate predictor in this patient population.

KW - Surgical audit

KW - Complications

KW - Aneurysm (abdominal aortic)

KW - Outcome

KW - VBHOM

KW - E-PASS

KW - GAS

U2 - 10.1016/j.ejvs.2007.07.019

DO - 10.1016/j.ejvs.2007.07.019

M3 - Journal article

VL - 34

SP - 505

EP - 513

JO - European Journal of Vascular and Endovascular Surgery

JF - European Journal of Vascular and Endovascular Surgery

SN - 1078-5884

IS - 5

ER -