Document Detail


Physiologic component of the estimation of physiologic ability and surgical stress scoring system as a predictor of immediate outcome after elective open abdominal aortic aneurysm repair.
MedLine Citation:
PMID:  21549917     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Previous studies have shown a good predictive power of the risk scoring method, Estimation of Physiologic Ability and Surgical Stress, in predicting mortality after open elective aortic aneurysm repair. The aim of the present study was to evaluate the physiologic component of this method to assess mortality risk in a different geographic population from previously published reports.
METHODS: Operative, morbidity and mortality data were collected retrospectively from charts of patients submitted to elective open repair of an abdominal aortic aneurysm over an 8-year period. There were 214 patients, the median age was 70 (range: 48-91) years; 179 (83.6%) patients were men. The Preoperative Physiologic Risk Score (PRS), Surgical Stress Score, and Comprehensive Risk Score (CRS) values were categorized and compared with morbidity and mortality rates.
RESULTS: There were 27 deaths (12.6%), and 81 (37.9%) patients experienced a postoperative complication that required medical intervention. There was a significant statistical difference for the values of PRS and CRS for patients who survived (0.53/0.63, respectively) and for those who died (0.88/1.02, respectively), p < 0.0001 for both values. There is a strong correlation between PRS and CRS values and development of complications (p < 0.0001). Surgical Stress Score did not correlate as strongly to development of complications (p = 0.0028). For PRS, the area under the receiver-operator characteristic curve was 0.844 (95% confidence interval: 0.747-0.941) for mortality and 0.725 (95% confidence interval: 0.650-0.799) for morbidity. For CRS, the area under the curve was 0.812 (95% confidence interval: 0.734-0.891) for mortality and 0.719 (95% confidence interval: 0.645-0.792) for morbidity. There was also a significant positive correlation between length of hospital stay and PRS and CRS scores (p < 0.0001). In this study, it was found that renal impairment has a significant positive correlation with mortality (p = 0.0008), with an odds ratio of 4.3. In a multivariate regression analysis, renal impairment failed to increase the accuracy of the model when associated with the other parameters considered in PRS.
CONCLUSION: This study corroborates with the previous findings that the Estimation of Physiologic Ability and Surgical Stress model seems to be a promising method of predicting death and postoperative complications in patients undergoing open abdominal aortic aneurysm repair.
Authors:
Fábio Hüsemann Menezes; Vinicius Meneguette Gomes de Souza
Related Documents :
16816087 - Acog practice bulletin no. 74. antibiotic prophylaxis for gynecologic procedures.
15630587 - One-stage correction of intermediate imperforate anus in males.
8522777 - Oral ciprofloxacin as prophylaxis in gastroduodenal surgery.
21251637 - Description and assessment of a common reference method for fluoroscopic and transesoph...
21712137 - Posttraumatic reconstruction of the hand-a retrospective review of 87 toe-to-hand trans...
21993937 - Laparoscopic duodenojejunal bypass with sleeve gastrectomy: preliminary results of a pr...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of vascular surgery     Volume:  25     ISSN:  1615-5947     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  485-95     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Division of Vascular Surgery, Department of Surgery, University of Campinas, Campinas, SP Brazil.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Is Use of a Continuous Autotransfusion System Beneficial in Emergency Abdominal Aortic Aneursym (AAA...
Next Document:  Longevity and outcomes of axillary valve transplantation for severe lower extremity chronic venous i...