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Identification of Risk Factors and Development of Predictive Risk Score Model for Mortality after Open Ruptured Abdominal Aortic Aneurysm Repair
Background and Objectives: Despite the relatively large number of publications concerning the validation of these models, there is currently no solid evidence that they can be used with absolute precision to predict survival. The goal of this study is to identify preoperative factors that influenced...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9028269/ https://www.ncbi.nlm.nih.gov/pubmed/35454387 http://dx.doi.org/10.3390/medicina58040549 |
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author | Tomic, Ivan Zlatanovic, Petar Markovic, Miroslav Sladojevic, Milos Mutavdzic, Perica Trailovic, Ranko Jovanovic, Ksenija Matejevic, David Milicic, Biljana Davidovic, Lazar |
author_facet | Tomic, Ivan Zlatanovic, Petar Markovic, Miroslav Sladojevic, Milos Mutavdzic, Perica Trailovic, Ranko Jovanovic, Ksenija Matejevic, David Milicic, Biljana Davidovic, Lazar |
author_sort | Tomic, Ivan |
collection | PubMed |
description | Background and Objectives: Despite the relatively large number of publications concerning the validation of these models, there is currently no solid evidence that they can be used with absolute precision to predict survival. The goal of this study is to identify preoperative factors that influenced 30-day mortality and to create a predictive model after open ruptured abdominal aortic aneurysm (RAAA) repair. Materials and Methods: This was a retrospective single-center cohort study derived from a prospective collected database, between 1 January 2009 and 2016. Multivariate logistic regression analysis was used to identify all significant predictive factors. Variables that were identified in the multivariate analysis were dichotomized at standard levels, and logistic regression was used for the analysis. To ensure that dichotomized variables were not overly simplistic, the C statistic was evaluated for both dichotomized and continuous models. Results: There were 500 patients with complete medical data included in the analysis during the study period. Of them, 37.6% were older than 74 years, and 83.8% were males. Multivariable logistic regression showed five variables that were predictive of mortality: age > 74 years (OR = 4.01, 95%CI 2.43–6.26), loss of consciousness (OR = 2.21, 95%CI 1.11–4.40), previous myocardial infarction (OR = 2.35, 95%CI 1.19–4.63), development of ventricular arrhythmia (OR = 4.54, 95%CI 1.75–11.78), and DAP < 60 mmHg (OR = 2.32, 95%CI 1.17–4.62). Assigning 1 point for each variable, patients were stratified according to the preoperative RAAA mortality risk score (range 0–5). Patients with 1 point suffered 15.3% mortality and 3 points 68.2% mortality, while all patients with 5 points died. Conclusions: This preoperative RAAA score identified risk factors readily assessed at the bedside and provides an accurate prediction of 30-day mortality after open repair of RAAA. |
format | Online Article Text |
id | pubmed-9028269 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-90282692022-04-23 Identification of Risk Factors and Development of Predictive Risk Score Model for Mortality after Open Ruptured Abdominal Aortic Aneurysm Repair Tomic, Ivan Zlatanovic, Petar Markovic, Miroslav Sladojevic, Milos Mutavdzic, Perica Trailovic, Ranko Jovanovic, Ksenija Matejevic, David Milicic, Biljana Davidovic, Lazar Medicina (Kaunas) Article Background and Objectives: Despite the relatively large number of publications concerning the validation of these models, there is currently no solid evidence that they can be used with absolute precision to predict survival. The goal of this study is to identify preoperative factors that influenced 30-day mortality and to create a predictive model after open ruptured abdominal aortic aneurysm (RAAA) repair. Materials and Methods: This was a retrospective single-center cohort study derived from a prospective collected database, between 1 January 2009 and 2016. Multivariate logistic regression analysis was used to identify all significant predictive factors. Variables that were identified in the multivariate analysis were dichotomized at standard levels, and logistic regression was used for the analysis. To ensure that dichotomized variables were not overly simplistic, the C statistic was evaluated for both dichotomized and continuous models. Results: There were 500 patients with complete medical data included in the analysis during the study period. Of them, 37.6% were older than 74 years, and 83.8% were males. Multivariable logistic regression showed five variables that were predictive of mortality: age > 74 years (OR = 4.01, 95%CI 2.43–6.26), loss of consciousness (OR = 2.21, 95%CI 1.11–4.40), previous myocardial infarction (OR = 2.35, 95%CI 1.19–4.63), development of ventricular arrhythmia (OR = 4.54, 95%CI 1.75–11.78), and DAP < 60 mmHg (OR = 2.32, 95%CI 1.17–4.62). Assigning 1 point for each variable, patients were stratified according to the preoperative RAAA mortality risk score (range 0–5). Patients with 1 point suffered 15.3% mortality and 3 points 68.2% mortality, while all patients with 5 points died. Conclusions: This preoperative RAAA score identified risk factors readily assessed at the bedside and provides an accurate prediction of 30-day mortality after open repair of RAAA. MDPI 2022-04-15 /pmc/articles/PMC9028269/ /pubmed/35454387 http://dx.doi.org/10.3390/medicina58040549 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Tomic, Ivan Zlatanovic, Petar Markovic, Miroslav Sladojevic, Milos Mutavdzic, Perica Trailovic, Ranko Jovanovic, Ksenija Matejevic, David Milicic, Biljana Davidovic, Lazar Identification of Risk Factors and Development of Predictive Risk Score Model for Mortality after Open Ruptured Abdominal Aortic Aneurysm Repair |
title | Identification of Risk Factors and Development of Predictive Risk Score Model for Mortality after Open Ruptured Abdominal Aortic Aneurysm Repair |
title_full | Identification of Risk Factors and Development of Predictive Risk Score Model for Mortality after Open Ruptured Abdominal Aortic Aneurysm Repair |
title_fullStr | Identification of Risk Factors and Development of Predictive Risk Score Model for Mortality after Open Ruptured Abdominal Aortic Aneurysm Repair |
title_full_unstemmed | Identification of Risk Factors and Development of Predictive Risk Score Model for Mortality after Open Ruptured Abdominal Aortic Aneurysm Repair |
title_short | Identification of Risk Factors and Development of Predictive Risk Score Model for Mortality after Open Ruptured Abdominal Aortic Aneurysm Repair |
title_sort | identification of risk factors and development of predictive risk score model for mortality after open ruptured abdominal aortic aneurysm repair |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9028269/ https://www.ncbi.nlm.nih.gov/pubmed/35454387 http://dx.doi.org/10.3390/medicina58040549 |
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