Universität zu Köln

Gawenda, M., Block, A., Majd, P. M. and Brunkwall, J. (2012). Is There a Role for Risk-Scoring Methods in Ruptured Abdominal Aortic Aneurysm (rAAA)? Zent.bl. Chir., 137 (5). S. 453 - 460. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1438-9592

Full text not available from this repository.

Abstract

Background: Rupture of an abdominal aortic aneurysm (rAAA) is associated with a high mortality both before and after admission to hospital. In spite of the use of expensive intensive medical therapeutic interventions 30 - 50 % of the operated patients still die. The ASA score is one of the most used scores world-wide. Use of the Glasgow aneurysm score (GAS) and the Hardman index (HI) is frequently reported in the literature to predict survival after surgical management of rAAA. With regard to the comorbidity factor severity score (CSS) no evaluated data on the mortality in cases of rAAA are available. On the basis of our own patient collective we intended to assess to what extent the risk score could give an answer to the question of therapeutic options. Methods: In a retrospective study (7/1998 - 8/2007), 94 patients (m : f = 78 : 16) were assessed after operative management of rAAA. The validity of preoperative risk assessments on the basis of the ASA score, the CSS, the GAS and the HI with regard to intra- or postoperative death in the initial hospitalisation period was examined. Sensitivity and specificity of the score systems were determined by receiver operating characteristics (ROC) analyses. Results: The age of the patients was 72.3 +/- 9.5 years (mean +/- SD). Thirty-five (37.2%) patients died in the immediate postoperative period. The areas under the receiver operating characteristics curves for ASA, GAS, HI and CSS were 0.598, 0.787, 0.742 and 0.614, respectively. Conclusions: This study revealed clear differences in the prognostic predictions of the various scores. In accord with the literature, no score gave a 100% positive result with regard to mortality. Thus, an individual decision or, respectively, a therapeutic option cannot be reached with the help of the investigated scores. Further parameters need to be evaluated in order to make decisions about postoperative therapy.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Gawenda, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Block, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Majd, P. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Brunkwall, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-481221
DOI:	10.1055/s-0031-1283885
Journal or Publication Title:	Zent.bl. Chir.
Volume:	137
Number:	5
Page Range:	S. 453 - 460
Date:	2012
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1438-9592
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PHYSICAL STATUS CLASSIFICATION; INDIVIDUAL PATIENT DATA; EMERGENCY OPEN REPAIR; HARDMAN INDEX; PERIOPERATIVE MORTALITY; CARDIAC RISK; SURGERY; PREDICTION; ANESTHESIOLOGISTS; ALLOCATION Multiple languages Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48122