RISK STRATIFICATION IN SELECTIVE SURGERY OF ABDOMINAL AORTIC ANEURYSM
https://doi.org/10.24884/0042-4625-2014-173-1-012-017
Abstract
A retrospective analysis of data of 188 patients, who underwent a selective surgery for abdominal aortic aneurism showed, that all the patients had a cardiac pathology. Ischemic heart disease and arterial hypertension had 175 (93,0%) and 177 (94,1%) of patients, respectively. Chronic nonspecific lung disease was noted in 65,4% patients and kidney disease — in 48,9%. Different complications developed in early postoperative period in 47 (25%) patients, that resulted in fatal outcome in 20 (10,6%). The most frequent complication was an acute renal insufficiency, which led to fatal outcome in 40% patients. Myocardial infarction and pneumonia took the second place in the structure of postoperative complications, one half of the fatal cases was due to these. Retrospective risk stratification assessment of the development of early postoperative complications and lethality was made by Glasgow Aneurysm Score (GAS) and angiosurgical model scale V-POSSUM. It was stated, that score was up to 84 according to GAS scale and up to 28 (V-POSSUM ). That fact is the evidence of high risk of the operation. On the basis of ROC curves building, the conclusion was made about greater predictive ability of V-POSSUM scoring system.
About the Authors
N. A. Yaitsky
Pavlov State Medical University
Russian Federation
Russian Federation
A. Ya. Bedrov
Pavlov State Medical University
Russian Federation
Russian Federation
A. A. Moiseev
Pavlov State Medical University
Russian Federation
Russian Federation
I. V. Nesterova
Pavlov State Medical University
Russian Federation
Russian Federation
References
1. Аракелян В. С., Чемурзиев Г. М., Ширинбек О. Тактика хирургического лечения аневризмы брюшной аорты у больных старше 70 лет // Грудная и серд.-сосуд. хир. 2007. № 5. С. 63–67.
2. Бокерия Л. А., Спиридонов А. А., Аракелян В. С. и др. Тактика хирургического лечения аневризмы брюшной аорты у больных старше 70 лет // Грудная и серд.-сосуд. хир. 2003. № 5. С. 34–39.
3. Казанчян П. О., Попов В. А., Мизиков В. М. Пути профилактики кардиальных осложнений при резекциях аневризм брюшной аорты // Ангиология и сосуд. хир. 1999. № 2. С. 63–78.
4. Логинов О. Е., Медведев А. П., Иванов Л. Н. и др. Профилактика периоперационных осложнений в плановой хирургии аневризм брюшной аорты // Мед. альманах. 2008. № 4. С. 144–145.
5. Покровский А. В., Дан В. Н., Златовчен А. М., Ильин С. А. Влияние кардиального статуса и артериальной гипертензии на результаты хирургического лечения больных с аневризмами брюшной аорты старше 70 лет // Ангиология и сосуд. хир. 2003. № 1. С. 71–76.
6. Хубулава Г. Г., Сазонов А. Б. Хирургическое лечение аневризм инфраренального сегмента аорты. СПб., 2009. 144 с.
7. Biancari F., Heikkinen M., Lepäntalo M. et al. Glasgow aneurysm score in patients undergoing elective open repair of abdominal aortic aneurysm: a finnvasc study // Eur. J. Vasc. Endovasc. Surg. 2003. Vol. 26. P. 612–617.
8. D’Angelo A. J., Puppala D., Farber A. et al. Is preoperative cardiac evaluation for abdominal aortic aneurysm repair necessary? // J. Vasc. Surg. 1997. Vol. 25. P. 152–156.
9. Hirzalla O., Emous M., Ubbink D. et al. External validation of the Glasgow Aneurysm Score to predict outcome in elective open abdominal aortic aneurysm repair // J. Vasc. Surg. 2006. Vol. 44. P. 712–716.
10. Midwinter M., Ashley S. Risk stratification in vascular patients using modified POSSUM scoring system // Br. J. Surg. 1997. Vol. 84. P. 568–572.
11. Samy A. K., Murray G., MacBain G. Glasgow Aneurysm Score // Cardiovasc. Surg. 1994. Vol. 2. P. 41–44.
Review
For citations:
Yaitsky N.A., Bedrov A.Ya., Moiseev A.A., Nesterova I.V. RISK STRATIFICATION IN SELECTIVE SURGERY OF ABDOMINAL AORTIC ANEURYSM. Grekov's Bulletin of Surgery. 2014;173(1):012-017. (In Russ.) https://doi.org/10.24884/0042-4625-2014-173-1-012-017
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