Early prediction of survival after open surgical repair of ruptured abdominal aortic aneurysms

• Published in: BMC surgery 2014-11, Vol.14 (1), p.92-92, Article 92
• Main Authors: Krenzien, Felix, Matia, Ivan, Wiltberger, Georg, Hau, Hans-Michael, Schmelzle, Moritz, Jonas, Sven, Kaisers, Udo X, Fellmer, Peter T
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Analysis; Aneurysms; Aortic Aneurysm, Abdominal - mortality; Aortic Aneurysm, Abdominal - surgery; Aortic Rupture - mortality; Aortic Rupture - surgery; Care and treatment; Diagnosis; Female; Follow-Up Studies; Germany - epidemiology; Health aspects; Hospital Mortality - trends; Hospitals; Humans; Intensive Care Units; Male; Medical research; Medicine, Experimental; Methods; Mortality; Multivariate Analysis; Odds Ratio; Patient outcomes; Physiological aspects; Prognosis; Retrospective Studies; ROC Curve; Severity of Illness Index; Studies; Survival Rate - trends; Time Factors; Vascular Surgical Procedures - methods
• ISSN: 1471-2482; 1471-2482
• DOI: 10.1186/1471-2482-14-92

Scoring models are widely established in the intensive care unit (ICU). However, the importance in patients with ruptured abdominal aortic aneurysm (RAAA) remains unclear. Our aim was to analyze scoring systems as predictors of survival in patients undergoing open surgical repair (OSR) for RAAA. This is a retrospective study in critically ill patients in a surgical ICU at a university hospital. Sixty-eight patients with RAAA were treated between February 2005 and June 2013. Serial measurements of Sequential Organ Failure Assessment score (SOFA), Simplified Acute Physiology Score II (SAPS II) and Simplified Therapeutic Intervention Scoring System-28 (TISS-28) were evaluated with respect to in-hospital mortality. Eleven patients had to be excluded from this study because 6 underwent endovascular repair and 5 died before they could be admitted to the ICU. All patients underwent OSR. The initial, highest, and mean of SOFA and SAPS II scores correlated significant with in-hospital mortality. In contrast, TISS-28 was inferior and showed a smaller area under the receiver operating curve. The cut-off point for SOFA showed the best performance in terms of sensitivity and specificity. An initial SOFA score below 9 predicted an in-hospital mortality of 16.2% (95% CI, 4.3-28.1) and a score above 9 predicted an in-hospital mortality of 73.7% (95% CI, 53.8-93.5, p 45), the in-hospital mortality rate was 85.7% (95% CI, 67.4-100, p