Biomechanical Rupture Risk Assessment in Management of Patients with Abdominal Aortic Aneurysm in COVID-19 Pandemic
Background: The acute phase of the COVID-19 pandemic requires a redefinition of healthcare system to increase the number of available intensive care units for COVID-19 patients. This leads to the postponement of elective surgeries including the treatment of abdominal aortic aneurysm (AAA). The proba...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-12-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/13/1/132 |
| _version_ | 1797626008547885056 |
|---|---|
| author | Lubos Kubicek Radek Vitasek David Schwarz Robert Staffa Petr Strakos Stanislav Polzer |
| author_facet | Lubos Kubicek Radek Vitasek David Schwarz Robert Staffa Petr Strakos Stanislav Polzer |
| author_sort | Lubos Kubicek |
| collection | DOAJ |
| description | Background: The acute phase of the COVID-19 pandemic requires a redefinition of healthcare system to increase the number of available intensive care units for COVID-19 patients. This leads to the postponement of elective surgeries including the treatment of abdominal aortic aneurysm (AAA). The probabilistic rupture risk index (PRRI) recently showed its advantage over the diameter criterion in AAA rupture risk assessment. Its major improvement is in increased specificity and yet has the same sensitivity as the maximal diameter criterion. The objective of this study was to test the clinical applicability of the PRRI method in a quasi-prospective patient cohort study. Methods: Nineteen patients (fourteen males, five females) with intact AAA who were postponed due to COVID-19 pandemic were included in this study. The PRRI was calculated at the baseline via finite element method models. If a case was diagnosed as high risk (PRRI > 3%), the patient was offered priority in AAA intervention. Cases were followed until 10 September 2021 and a number of false positive and false negative cases were recorded. Results: Each case was assessed within 3 days. Priority in intervention was offered to two patients with high PRRI. There were four false positive cases and no false negative cases classified by PRRI. In three cases, the follow-up was very short to reach any conclusion. Conclusions: Integrating PRRI into clinical workflow is possible. Longitudinal validation of PRRI did not fail and may significantly decrease the false positive rate in AAA treatment. |
| first_indexed | 2024-03-11T10:04:30Z |
| format | Article |
| id | doaj.art-0008db1cccdd4b66b94bc7b27cec9d9d |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T10:04:30Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-0008db1cccdd4b66b94bc7b27cec9d9d2023-11-16T15:09:16ZengMDPI AGDiagnostics2075-44182022-12-0113113210.3390/diagnostics13010132Biomechanical Rupture Risk Assessment in Management of Patients with Abdominal Aortic Aneurysm in COVID-19 PandemicLubos Kubicek0Radek Vitasek1David Schwarz2Robert Staffa3Petr Strakos4Stanislav Polzer52nd Department of Surgery, St. Anne’s University Hospital Brno and Faculty of Medicine, Masaryk University, 612 00 Brno, Czech RepublicDepartment of Applied Mechanics, VSB-Technical University of Ostrava, 708 00 Ostrava, Czech RepublicDepartment of Applied Mechanics, VSB-Technical University of Ostrava, 708 00 Ostrava, Czech Republic2nd Department of Surgery, St. Anne’s University Hospital Brno and Faculty of Medicine, Masaryk University, 612 00 Brno, Czech RepublicIT4Innovations, VSB—Technical University of Ostrava, 708 00 Ostrava, Czech RepublicDepartment of Applied Mechanics, VSB-Technical University of Ostrava, 708 00 Ostrava, Czech RepublicBackground: The acute phase of the COVID-19 pandemic requires a redefinition of healthcare system to increase the number of available intensive care units for COVID-19 patients. This leads to the postponement of elective surgeries including the treatment of abdominal aortic aneurysm (AAA). The probabilistic rupture risk index (PRRI) recently showed its advantage over the diameter criterion in AAA rupture risk assessment. Its major improvement is in increased specificity and yet has the same sensitivity as the maximal diameter criterion. The objective of this study was to test the clinical applicability of the PRRI method in a quasi-prospective patient cohort study. Methods: Nineteen patients (fourteen males, five females) with intact AAA who were postponed due to COVID-19 pandemic were included in this study. The PRRI was calculated at the baseline via finite element method models. If a case was diagnosed as high risk (PRRI > 3%), the patient was offered priority in AAA intervention. Cases were followed until 10 September 2021 and a number of false positive and false negative cases were recorded. Results: Each case was assessed within 3 days. Priority in intervention was offered to two patients with high PRRI. There were four false positive cases and no false negative cases classified by PRRI. In three cases, the follow-up was very short to reach any conclusion. Conclusions: Integrating PRRI into clinical workflow is possible. Longitudinal validation of PRRI did not fail and may significantly decrease the false positive rate in AAA treatment.https://www.mdpi.com/2075-4418/13/1/132abdominal aortic aneurysmbiomechanicsrupture riskpredictabilityCOVID-19 |
| spellingShingle | Lubos Kubicek Radek Vitasek David Schwarz Robert Staffa Petr Strakos Stanislav Polzer Biomechanical Rupture Risk Assessment in Management of Patients with Abdominal Aortic Aneurysm in COVID-19 Pandemic Diagnostics abdominal aortic aneurysm biomechanics rupture risk predictability COVID-19 |
| title | Biomechanical Rupture Risk Assessment in Management of Patients with Abdominal Aortic Aneurysm in COVID-19 Pandemic |
| title_full | Biomechanical Rupture Risk Assessment in Management of Patients with Abdominal Aortic Aneurysm in COVID-19 Pandemic |
| title_fullStr | Biomechanical Rupture Risk Assessment in Management of Patients with Abdominal Aortic Aneurysm in COVID-19 Pandemic |
| title_full_unstemmed | Biomechanical Rupture Risk Assessment in Management of Patients with Abdominal Aortic Aneurysm in COVID-19 Pandemic |
| title_short | Biomechanical Rupture Risk Assessment in Management of Patients with Abdominal Aortic Aneurysm in COVID-19 Pandemic |
| title_sort | biomechanical rupture risk assessment in management of patients with abdominal aortic aneurysm in covid 19 pandemic |
| topic | abdominal aortic aneurysm biomechanics rupture risk predictability COVID-19 |
| url | https://www.mdpi.com/2075-4418/13/1/132 |
| work_keys_str_mv | AT luboskubicek biomechanicalruptureriskassessmentinmanagementofpatientswithabdominalaorticaneurysmincovid19pandemic AT radekvitasek biomechanicalruptureriskassessmentinmanagementofpatientswithabdominalaorticaneurysmincovid19pandemic AT davidschwarz biomechanicalruptureriskassessmentinmanagementofpatientswithabdominalaorticaneurysmincovid19pandemic AT robertstaffa biomechanicalruptureriskassessmentinmanagementofpatientswithabdominalaorticaneurysmincovid19pandemic AT petrstrakos biomechanicalruptureriskassessmentinmanagementofpatientswithabdominalaorticaneurysmincovid19pandemic AT stanislavpolzer biomechanicalruptureriskassessmentinmanagementofpatientswithabdominalaorticaneurysmincovid19pandemic |