Preoperative risk stratification in patients undergoing elective infrarenal aortic aneurysm surgery: Evaluation of five risk scoring methods
Preoperative risk stratification in patients undergoing elective infrarenal aortic aneurysm surgery: Evaluation of five risk scoring methods
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DOI：
10.1016/j.ejvs.2004.02.010
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发表时间：
2004-07-01
影响因子：
5.7
通讯作者：
Juvonen, T
中科院分区：
文献类型：
--
作者：
Nesi, F;Leo, E;Juvonen, T
客观的。评估五种风险评分方法来预测腹主动脉瘤（AAA）选择性开放修复术后即刻术后结果。设计。对连续系列患者的 Eagle 评分、Glasgow 动脉瘤评分、Leiden 评分、改良 Leiden 评分和 Vanzetto 评分进行回顾性评估。 286 名连续患者接受选择性肾下主动脉瘤修复术。结果。 9 名患者 (3.1%) 在医院死亡，另有 35 名患者 (12%) 出现严重的术后并发症。对于预测院内死亡率的格拉斯哥动脉瘤评分、Leiden 评分、改良 Leiden 评分和 Vanzetto 评分接受者操作特征 (ROC) 曲线分析显示，曲线下面积 (AUC) 分别为 0.749 (p = 0.01)、0.777 (p = 0.008)、0.788 (p = 0.006) 和 0.794 (p = 0.005），分别。 Eagle 风险评分对于预测院内死亡率不太准确。风险评分系统在预测术后并发症方面表现不佳，但多变量分析显示改良Leiden评分是术后并发症的独立预测因子。结论。所有评分系统都能以合理的准确性预测接受 AAA 择期开放修复术的患者的院内死亡风险，而预测严重术后并发症的准确性较低。
Objective. To evaluate five risk scoring methods in predicting the immediate postoperative outcome after elective open repair of abdominal aortic aneurysm (AAA).Design. Retrospective evaluation of the Eagle score, Glasgow aneurysm score, Leiden score, modified Leiden score and Vanzetto score in a consecutive series of patients.Patients. Two hundred and eighty-six consecutive patients undergoing elective infrarenal aortic aneurysm repair.Results. Nine patients (3.1%) died in hospital and another 35 (12%) experienced severe postoperative complications. For the Glasgow aneurysm score, Leiden score, modified Leiden score and Vanzetto score receiver operating characteristics (ROC) curve analysis for prediction of in-hospital mortality showed area under the curve (AUC) of 0.749 (p = 0.01), 0.777 (p = 0.008), 0.788 (p = 0.006) and 0.794 (p = 0.005), respectively. The Eagle risk score was less accurate for predicting in-hospital mortality. The risk-scoring systems did not perform well in predicting post-operative complications, but multivariate analysis showed that the modified Leiden score was an independent predictor of postoperative complications.Conclusion. All scoring systems predict, with reasonable accuracy, the risk of in-hospital death in patients undergoing elective open repair of AAA, whereas the accuracy in predicting severe postoperative complications is less.