Biancari F, Leo E, Ylönen K, Vaarala M H, Rainio P, Juvonen T
Division of Cardiothoracic and Vascular Surgery, University of Oulu, Oulu, Finland.
Br J Surg. 2003 Jul;90(7):838-44. doi: 10.1002/bjs.4130.
This study aimed to explore the value of the Glasgow Aneurysm Score in predicting the immediate and long-term outcome after elective open repair of abdominal aortic aneurysm (AAA).
Some 403 patients underwent elective open repair of an infrarenal AAA and were classified retrospectively according to the criteria of the Glasgow Aneurysm Score (risk score = (age in years) + (7 for myocardial disease) + (10 for cerebrovascular disease) + (14 for renal disease)).
Fourteen patients (3.5 per cent) died after operation, 23 (5.7 per cent) had a myocardial infarction and six (1.5 per cent) had a stroke. One hundred and nine patients (27.0 per cent) experienced severe postoperative complications. The Glasgow Aneurysm Score was predictive of postoperative death (area under the receiver-operator characteristic curve (AUC) 0.80, 95 per cent confidence interval (c.i.) 0.71 to 0.90), severe postoperative complications (AUC 0.67, 95 per cent c.i. 0.61 to 0.73), myocardial infarction (AUC 0.72, 95 per cent c.i. 0.62 to 0.82), myocardial infarction-related postoperative death (AUC 0.78, 95 per cent c.i. 0.63 to 0.94) and stroke (AUC 0.84, 95 per cent c.i. 0.74 to 0.95). Univariate analysis showed that this risk index was also predictive of long-term survival.
The Glasgow Aneurysm Score is a good predictor of outcome after elective open repair of AAA. Its simplicity and accuracy make it useful for preoperative risk stratification.
本研究旨在探讨格拉斯哥动脉瘤评分在预测腹主动脉瘤(AAA)择期开放修复术后近期和远期结局中的价值。
约403例患者接受了肾下腹主动脉瘤择期开放修复术,并根据格拉斯哥动脉瘤评分标准进行回顾性分类(风险评分=(年龄,岁)+(心肌病为7)+(脑血管病为10)+(肾病为14))。
14例患者(3.5%)术后死亡,23例(5.7%)发生心肌梗死,6例(1.5%)发生卒中。109例患者(27.0%)出现严重术后并发症。格拉斯哥动脉瘤评分可预测术后死亡(受试者工作特征曲线下面积(AUC)0.80,95%置信区间(c.i.)0.71至0.90)、严重术后并发症(AUC 0.67,95% c.i. 0.61至0.73)、心肌梗死(AUC 0.72,95% c.i. 0.62至0.82)、心肌梗死相关术后死亡(AUC 0.78,95% c.i. 0.63至0.94)和卒中(AUC 0.84,95% c.i. 0.74至0.95)。单因素分析显示该风险指数也可预测长期生存。
格拉斯哥动脉瘤评分是腹主动脉瘤择期开放修复术后结局的良好预测指标。其简单性和准确性使其在术前风险分层中有用。