Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Vascular Surgery, Berlin, Germany.
Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Vascular Surgery, Berlin, Germany.
J Cardiothorac Vasc Anesth. 2021 Dec;35(12):3700-3707. doi: 10.1053/j.jvca.2021.08.015. Epub 2021 Aug 14.
This study's objective was to compare several preoperative and intensive care unit (ICU) prognostic scoring systems for predicting the in-hospital mortality of ruptured abdominal aortic aneurysms (RAAAs).
Retrospective cohort study.
Single tertiary university center.
The study comprised 157 patients.
None.
A total of 157 patients (82% male) presented with RAAA at Charité University Hospital from January 2011 to December 2020. The mean age was 74 years (standard deviation ten years). In-hospital mortality was 29% (n = 45), of whom nine patients (6%) died en route to the operating room, 13 (8%) on the operating table, and 23 (15%) in the ICU. A total of 135 patients (86%) were admitted to the ICU. All six models demonstrated good discriminating performance between survivors and nonsurvivors. Overall, the area under the curve (AUC) for RAAA preoperative scores was greater than those for ICU scores. The largest AUC was achieved with the Vascular Study Group of New England (VSGNE) RAAA risk score (AUC = 0.87 for all patients, AUC = 0.84 for patients admitted to the ICU), followed by Hardman Index (AUC = 0.83 for all patients, AUC = 0.81 for patients admitted to the ICU), and Glasgow Aneurysm Score (AUC = 0.74 for all patients, AUC = 0.83 for patients admitted to the ICU). The largest AUC for ICU scores (only patients admitted to the ICU) was achieved with Simplified Acute Physiology Score II (0.75), followed by Sepsis-related Organ Failure Assessment (0.73), and Acute Physiology and Chronic Health Evaluation II (0.71).
Preoperative and ICU scores can predict the mortality of patients presenting with RAAA. In addition, the discriminatory ability of preoperative scores between survivors and nonsurvivors was larger than that for ICU scores.
本研究旨在比较几种术前和重症监护病房（ICU）预后评分系统，以预测破裂性腹主动脉瘤（RAAA）患者的院内死亡率。
回顾性队列研究。
单所三级大学中心。
研究纳入了 157 例患者。
无。
2011 年 1 月至 2020 年 12 月，Charité 大学医院共收治 157 例 RAAA 患者（82%为男性），平均年龄为 74 岁（标准差为 10 年）。院内死亡率为 29%（n=45），其中 9 例（6%）在转运至手术室途中死亡，13 例（8%）在手术台上死亡，23 例（15%）在 ICU 死亡。共有 135 例（86%）患者被收入 ICU。所有 6 种模型均能较好地区分存活者和非存活者。总体而言，RAAA 术前评分的曲线下面积（AUC）大于 ICU 评分。Vascular Study Group of New England（VSGNE）RAAA 风险评分的 AUC 最大（所有患者的 AUC=0.87，入住 ICU 的患者的 AUC=0.84），其次是 Hardman 指数（所有患者的 AUC=0.83，入住 ICU 的患者的 AUC=0.81）和 Glasgow 动脉瘤评分（所有患者的 AUC=0.74，入住 ICU 的患者的 AUC=0.83）。ICU 评分（仅入住 ICU 的患者）的 AUC 最大为简化急性生理学评分 II（0.75），其次是脓毒症相关器官衰竭评估（0.73）和急性生理学和慢性健康评估 II（0.71）。
术前和 ICU 评分可预测 RAAA 患者的死亡率。此外，术前评分区分存活者和非存活者的能力大于 ICU 评分。
