Risk prediction in patients undergoing elective endovascular repair of an abdominal aortic aneurysm.
OBJECTIVE
The aim of this study was to retrospectively evaluate three risk scoring methods in predicting outcome after elective endovascular repair of an abdominal aortic aneurysm.


METHODS
A Zenith stent graft was employed in 205 patients during years 2001-2005.


RESULTS
The 30-day postoperative mortality rate was 2.9%. Receiver operating characteristics (ROC) curve analysis showed that the Glasgow aneurysm score (GAS) (AUC: 0.843, p=0.004) and the Giles' score (AUC 0.815, p=0.009) had a rather large area under the curve in predicting 30-day mortality rate. The modified Leiden score was much less accurate (AUC: 0.594). The best cut-off value for the GAS in predicting 30-day mortality was 90 (0.6% vs. 17.9%, p<0.0001). Patients with a GAS > or = 90 had a 4-year survival rate of 56.8%, whereas it was 78.5% among those with a lower GAS (p = 0.001). The best cut-off value for the Giles' score was 11 (1.3% vs. 8.3%, p<0.0001). Patients with a Giles' score > or = 11 had a 4-year survival rate of 63.9%, whereas it was 79.0% among those with a lower score (p = 0.016).


CONCLUSIONS
The GAS and Giles' risk scoring methods are good predictors of poor immediate and late outcome after EVAR.
Nevala
Terhi
T
Department of Radiology, Oulu University Hospital, Oulu, Finland. Terhi.Nevala@ppshp.fi
Biancari
Fausto
F
Perälä
Jukka
J
Manninen
Hannu
H
Aho
Pekka-Sakari
PS
Matsi
Pekka
P
Mäkinen
Kimmo
K
Roth
Wolf-Dieter
WD
Ylönen
Kari
K
Lepäntalo
Mauri
M
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D017558:Elective Surgical Procedures; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome