title: Glasgow aneurysm score predicts the outcome after emergency open repair of symptomatic, unruptured abdominal aortic aneurysms.
abstract: OBJECTIVE
  To determine the predictor factors of in-hospital postoperative mortality in patients presenting with symptomatic but not ruptured abdominal aortic aneurysm (AAA) at our institution.
  
  
  METHODS
  Forty-two patients who underwent urgent open repair for symptomatic, non-ruptured AAA were evaluated retrospectively.
  
  
  RESULTS
  Five patients (11.9%) died during the in-hospital stay. History of coronary artery disease (p=0.014), cerebrovascular diseases (p=0.015), renal failure according to Glasgow Aneurysm Score (GAS) criteria (p=0.001), serum creatinine concentration (p=0.026), and the GAS (p=0.008) were predictive of postoperative death. The ROC curve analysis showed that the Glasgow Aneurysm Score had an area under the curve of 0.870 (95%C.I. 0.71-1, S.E. 0.08, p=0.008), and its best cut-off value in predicting postoperative death was 90.0 (specificity 89.2%, sensitivity 80.0%). The postoperative mortality rate of patients with a Glasgow Aneurysm Score below 90 was 2.9%, whereas it was 50% for those with a score >or=90 (p=0.003, O.R. 33.0).
  
  
  CONCLUSIONS
  This study shows that the Glasgow Aneurysm Score is a good predictor of postoperative mortality and morbidity after urgent repair of symptomatic, non-ruptured AAA and can be useful in identifying those patients whose operative risk is prohibitive. Its simplicity makes it a clinically important tool, particularly, in the emergency setting. Patients having a score less than 90 can safely undergo urgent open repair. Thorough evaluation and improvement of preoperative status followed preferably by an endovascular repair is indicated for those with a score >or=90.
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, Vascular Surgery Section, Padua University Hospital, Italy. michele.antonello.1@unipd.it
authors.forename: M
authors.initials: M
authors.lastname: Antonello
authors.forename: S
authors.initials: S
authors.lastname: Lepidi
authors.forename: A
authors.initials: A
authors.lastname: Kechagias
authors.forename: P
authors.initials: P
authors.lastname: Frigatti
authors.forename: A
authors.initials: A
authors.lastname: Tripepi
authors.forename: F
authors.initials: F
authors.lastname: Biancari
authors.forename: G P
authors.initials: GP
authors.lastname: Deriu
authors.forename: F
authors.initials: F
authors.lastname: Grego
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D004632:Emergency Medical Services; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects