Glasgow Aneurysm Score Predicts the Outcome after Emergency Open Repair of Symptomatic, Unruptured Abdominal Aortic Aneurysms

• Published in: European journal of vascular and endovascular surgery 2007-03, Vol.33 (3), p.272-276
• Main Authors: Antonello, M, Lepidi, S, Kechagias, A, Frigatti, P, Tripepi, A, Biancari, F, Deriu, G.P, Grego, F
• Format: Article
• Language: English
• Subjects: Aged; Aortic Aneurysm, Abdominal - surgery; Emergency; Emergency Medical Services; Female; Glasgow aneurysm score; Health Status Indicators; Humans; Male; Postoperative Complications - epidemiology; Retrospective Studies; ROC Curve; Sensitivity and Specificity; Surgery; Symptomatic aneurysm; Treatment Outcome; Unruptured abdominal aortic aneurysm; Vascular Surgical Procedures - adverse effects
• ISSN: 1078-5884; 1532-2165
• DOI: 10.1016/j.ejvs.2006.09.006

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. Patients and 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 ≥ 90 ( p = 0.003, O.R. 33.0). Conclusion 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 ≥ 90.