Research output: Contribution to Journal/Magazine › Journal article › peer-review
Comparison of risk-scoring methods in predicting the immediate outcome after elective open abdominal aneurysm surgery. / Tang, Tjun; Walsh, S.R.; Fanshawe, Thomas et al.
In: European Journal of Vascular and Endovascular Surgery, Vol. 34, No. 5, 11.2007, p. 505-513.Research output: Contribution to Journal/Magazine › Journal article › peer-review
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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 -