Preoperative risk stratification in patients undergoing elective infrarenal aortic aneurysm surgery: evaluation of five risk scoring methods.
OBJECTIVE
To evaluate five risk scoring methods in predicting the immediate postoperative outcome after elective open repair of abdominal aortic aneurysm (AAA).


METHODS
Retrospective evaluation of the Eagle score, Glasgow aneurysm score, Leiden score, modified Leiden score and Vanzetto score in a consecutive series of patients.


METHODS
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.


CONCLUSIONS
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.
Nesi
F
F
Division of Vascular Surgery, Department of Cardiovascular Sciences, San Camillo-Forlanini Hospital, 00152 Rome, Italy.
Leo
E
E
Biancari
F
F
Bartolucci
R
R
Rainio
P
P
Satta
J
J
Rabitti
G
G
Juvonen
T
T
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000453:epidemiology* / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D023261:Glasgow Outcome Scale; D017052:Hospital Mortality; D006801:Humans; D017543:Iliac Aneurysm / Q000453:epidemiology / Q000601:surgery; D007558:Italy; D007668:Kidney / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome