Glasgow aneurysm score in predicting outcome after ruptured abdominal aortic aneurysm.
OBJECTIVE
To assess the ability of Glasgow Aneurysm Score in predicting postoperative mortality for ruptured aortic aneurysm which may assist in decision making regarding the open surgical repair of an individual patient.


METHODS
A total of 121 patients diagnosed of ruptured abdominal aortic aneurysm who underwent open surgery in our hospital between 1999 and 2013 were included. The Glasgow Aneurysm Score for each patient was graded according to the Glasgow Aneurysm Score (Glasgow Aneurysm Score = age in years + 17 for shock + 7 for myocardial disease + 10 for cerebrovascular disease + 14 for renal disease). The groups were divided as Group 1 (containing the patients who died) and Group 2 (the patients who were discharged). The Glasgow Aneurysm Scores amongst the groups were compared.


RESULTS
Out of 121 patients, 108 (89.3%) were males and 13 (10.7%) were females. The in-hospital mortality was 48 patients (39.7%). The Glasgow Aneurysm Score was 84.15 ± 15.94 in Group 1 and 75.14 ± 14.67 in Group 2 which revealed significance (p = 0.002). The most appropriate cut-off value for Glasgow Aneurysm Score was determined as 78.5 (AUC = 0.669, p = 0.002, sensitivity: 64.6%, specificity: 60.3%). Glasgow Aneurysm Score value above 78.5 is associated with almost threefold increase in mortality (p = 0.007, OR:2.76, 95% CI 1.30-5.89). In further logistic regression models, Glasgow Aneurysm Score value and preoperative hematocrit values were found to be independent predictors for mortality (p = 0.023 and p = 0.007, respectively).


CONCLUSIONS
Glasgow Aneurysm Score may have a predictive value for outcome of patients with ruptured abdominal aortic aneurysm undergoing open surgical procedure and it appears to be a useful tool in clinical decision-making of an individual patient when integrated with clinical experience.
Türkiye Yüksek İhtisas Hospital, Cardiovascular Surgery Clinic, Ankara, Turkey.
Anıl
A
Özen
Türkiye Yüksek İhtisas Hospital, Cardiovascular Surgery Clinic, Ankara, Turkey utkuunal@gmail.com.
Ertekin Utku
EU
Unal
Türkiye Yüksek İhtisas Hospital, Cardiovascular Surgery Clinic, Ankara, Turkey.
Serkan
S
Mola
Türkiye Yüksek İhtisas Hospital, Cardiovascular Surgery Clinic, Ankara, Turkey.
Ibrahim
I
Erkengel
Türkiye Yüksek İhtisas Hospital, Cardiovascular Surgery Clinic, Ankara, Turkey.
Erman
E
Kiris
Türkiye Yüksek İhtisas Hospital, Cardiovascular Surgery Clinic, Ankara, Turkey.
Aysen
A
Aksöyek
Türkiye Yüksek İhtisas Hospital, Cardiovascular Surgery Clinic, Ankara, Turkey.
Ahmet
A
Saritas
Türkiye Yüksek İhtisas Hospital, Cardiovascular Surgery Clinic, Ankara, Turkey.
Cemal Levent
CL
Birincioğlu
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis* / Q000601:surgery*; D001019:Aortic Rupture / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
Risk assessment; mortality; ruptured aortic aneurysm; surgery