择期开放性腹主动脉瘤手术后患者急性肾损伤预测中V-POSSUM和E-PASS评分的评估
Estimation of V-POSSUM and E-PASS Scores in Prediction of Acute Kidney Injury in Patients after Elective Open Abdominal Aortic Aneurysm Surgery.
作者信息
Siemiatkowski Andrzej, Jablonowska Agnieszka, Pietrewicz Joanna, Glowinski Jerzy
机构信息
Department of Anesthesiology and Intensive Therapy, Medical University of Bialystok, Bialystok, Poland.
Department of Anesthesiology and Intensive Therapy, Medical University of Bialystok, Bialystok, Poland.
出版信息
Ann Vasc Surg. 2017 Jul;42:189-197. doi: 10.1016/j.avsg.2017.02.006. Epub 2017 Mar 28.
BACKGROUND
V-POSSUM and E-PASS scoring systems are usually used to predict morbidity and early mortality in surgical patients. We conducted this study to assess the validity of the V-POSSUM and E-PASS scores in predicting risk of acute kidney injury (AKI) development in patients undergoing elective open abdominal aortic aneurysm (AAA) repair.
METHODS
We studied a consecutive series of 171 patients with AAA, qualified for elective open infrarenal repair. Patients underwent a thorough examination, and the physiological and surgical stress components of the V-POSSUM and E-PASS scores were calculated. The classification of patients in terms of postoperative AKI was performed in accordance with KDIGO criteria.
RESULTS
AKI was recognized in 62 patients. In these patients, we found significantly higher physiological and surgical stress components of V-POSSUM and E-PASS scores in relation to patients without AKI. ROC analysis showed that the E-PASS score with a cutoff point ≥0.796 and the V-POSSUM score (morbidity) with a cutoff point ≥77.2% with sensitivity of 75.8% and 74.2%, respectively, and with specificity of 83.5% for both, identified patients with postoperative AKI.
CONCLUSIONS
V-POSSUM and E-PASS scores have similar good properties in predicting postoperative AKI in patients undergoing elective open AAA repair.
背景
V-POSSUM和E-PASS评分系统通常用于预测外科手术患者的发病率和早期死亡率。我们开展这项研究以评估V-POSSUM和E-PASS评分在预测择期开放性腹主动脉瘤（AAA）修复患者发生急性肾损伤（AKI）风险方面的有效性。
方法
我们研究了连续的171例AAA患者，这些患者适合进行择期开放性肾下修复。患者接受了全面检查，并计算了V-POSSUM和E-PASS评分的生理和手术应激成分。根据KDIGO标准对患者术后AKI进行分类。
结果
62例患者被诊断为AKI。在这些患者中，我们发现与未发生AKI的患者相比，V-POSSUM和E-PASS评分的生理和手术应激成分明显更高。ROC分析显示，E-PASS评分截断点≥0.796以及V-POSSUM评分（发病率）截断点≥77.2%时，分别具有75.8%和74.2%的敏感性，两者特异性均为83.5%，可识别术后发生AKI的患者。
结论
V-POSSUM和E-PASS评分在预测择期开放性AAA修复患者术后AKI方面具有相似的良好性能。
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