New scale for predicting mortality in ruptured abdominal aortic aneurysms

Introduction: To determine the usefulness of mortality risk scores for the endovascular treatment of ruptured abdominal aortic aneurysms.

Methods: Retrospective study of 61 patients undergoing endovascular repair between 2009 and 2014. Preoperative variables and in-hospital mortality were collected. The Hardman, GAS, Vancouver and ERAS scales were calculated.

Results: In-hospital mortality was 45.9%. The univariate predictors obtained were age, male sex, hypertension, smoking, chronic obstructive pulmonary disease, systolic blood pressure <90mmHg, heart rate and loss of consciousness. After completing the multivariate analysis, significant variables were age (P=.021), systolic blood pressure <90mmHg (P=.004) and heart rate (P=.050). The GAS (76.79±9.88 vs. 90.43±14.76, P=.001), Vancouver (4.41±0.62 vs. 4.83±0.55, P=.007) and ERAS scales (0.06±0.24 vs. 0.86±0.76, P=.001) were statistically different between the groups. The scale resulting from the following formula: 0.083+0.158 (if age>80 years)+0.701 (if systolic blood pressure<80mmHg)+0.598 (if heart rate<70 beats/min); obtained an area under the curve of 0.95.

Conclusions: Age, systolic pressure and heart rate, are predictors of hospital mortality of patients treated with endovascular repair of ruptured abdominal aortic aneurysms. Applying the scale proposed in this study, in combination with GAS, Vancouver and ERAS scales, allows the detection of patients who would not benefit from endovascular treatment.