Prediction of 30-day mortality after endovascular repair or open surgery in patients with ruptured abdominal aortic aneurysms

Abstract

We showed limited discriminative ability of the GAS and therefore updated the GAS by adding the type of procedure performed. This updated prediction rule predicts 30-day mortality for patients with ruptured AAAs treated with endovascular repair or open surgery.

Editor's Choice - External Validation of Models Predicting Survival After Ruptured Abdominal Aortic Aneurysm Repair

“…Second, the number of patients included (n ¼ 449) was higher than the previous largest study (n ¼ 201). 13 Finally, the updated GAS and Vancouver score were recalibrated to improve accuracy in the era of EVAR. Because of the large number of missing ECGs, no definite conclusions could be drawn for the Hardman index.…”

“…13,22e26 In the only previous study including patients treated with EVAR, the AUC was 0.70 (95% CI 0.62e0.77). 13 The calibration of the updated GAS was not assessed in this previous study. The strength of the previous validation (201 patients included, multicenter, prospective, including EVAR and OR) 13 confirms the conclusion that the updated GAS is the most accurate in predicting death after intervention for a RAAA.…”

“…13 The calibration of the updated GAS was not assessed in this previous study. The strength of the previous validation (201 patients included, multicenter, prospective, including EVAR and OR) 13 confirms the conclusion that the updated GAS is the most accurate in predicting death after intervention for a RAAA. If clinicians consider their patients to be comparable with those included in the present study, the model as shown in Fig.…”

“…2 Only the GAS has been updated to the era of EVAR by the addition of a variable for type of intervention. 13 The primary objective of the present study was to assess the accuracy of the updated GAS (the model including differentiation between EVAR and OR), the Vancouver score, the ERAS, and the Hardman index in predicting death. Only extremely reliable models, those predicting death accurately in more than 95% of cases, may be useful in clinical decision making.…”

Evaluation of the Perioperative Risk Factors in Patients with the Abdominal Aorta Aneurysm - Literature Review

“…Mortality risk can be assessed basing on such data as: age, shock at admission, presence of ischemic heart disease, cerebrovascular disease, renal failure (10). Numerous studies indicate that this scale is currently sued and recommended for estimating the risk of death in high risk patients, in particular with ruptured AAA, undergoing open or endovascular surgical procedure (11,12).…”