Preoperative risk score accuracy confirmed in a modern ruptured abdominal aortic aneurysm experience

Various risk score calculators used to predict 30-day mortality after treatment of ruptured abdominal aortic aneurysms (rAAAs) have produced mixed results regarding their usefulness and reproducibility. We prospectively validated the accuracy of our preoperative scoring system in a modern cohort of...

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Bibliographic Details
Published in:Journal of vascular surgery 2021-11, Vol.74 (5), p.1508-1518
Main Authors: Hemingway, Jake F., French, Bryce, Caps, Michael, Benyakorn, Thoetphum, Quiroga, Elina, Tran, Nam, Singh, Niten, Starnes, Benjamin W.
Format: Article
Language:English
Subjects:
Abdominal aortic aneurysms
Age Factors
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - diagnosis
Aortic Aneurysm, Abdominal - mortality
Aortic Aneurysm, Abdominal - physiopathology
Aortic Aneurysm, Abdominal - surgery
Aortic Rupture - diagnosis
Aortic Rupture - mortality
Aortic Rupture - physiopathology
Aortic Rupture - surgery
Biomarkers - blood
Blood Pressure
Blood Vessel Prosthesis Implantation - adverse effects
Blood Vessel Prosthesis Implantation - mortality
Creatinine - blood
Databases, Factual
Decision Support Techniques
Endovascular Procedures - adverse effects
Endovascular Procedures - mortality
Female
Harborview
Humans
Hydrogen-Ion Concentration
Hypotension - physiopathology
Hypotension - surgery
Male
Predictive Value of Tests
Prospective Studies
Reproducibility of Results
Retrospective Studies
Risk Assessment
Risk Factors
Ruptured
Time Factors
Treatment Outcome
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Summary:Various risk score calculators used to predict 30-day mortality after treatment of ruptured abdominal aortic aneurysms (rAAAs) have produced mixed results regarding their usefulness and reproducibility. We prospectively validated the accuracy of our preoperative scoring system in a modern cohort of patients with rAAAs. A retrospective review of all patients wiith rAAAs who had presented to a single academic center from January 2002 to December 2018 was performed. The patients were divided into three cohorts according to when the institutional practice changes had occurred: the pre-endovascular aneurysm repair (EVAR) era (January 2002 to July 2007), the pre-Harbor View risk score era (August 2007 to October 2013), and the modern era (November 2013 to December 2018). The primary outcome measure was 30-day mortality. Our preoperative risk score assigns 1 point for each of the following: age >76 years, pH 2 mg/dL, and any episode of hypotension (systolic blood pressure 
ISSN:0741-5214
1097-6809
DOI:10.1016/j.jvs.2021.04.043