Glasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm?
Abstract Background To evaluate the value of Glasgow Aneurysm Score (GAS) in predicting long-term mortality and survival in patients who have undergone endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Methods A retrospective single-center study of 257 patients with non...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-11-01
|
| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-021-02366-y |
| _version_ | 1818345179275329536 |
|---|---|
| author | Anıl Özen Metin Yılmaz Görkem Yiğit İsa Civelek Mehmet Ali Türkçü Ferit Çetinkaya Ertekin Utku Ünal Hakkı Zafer İşcan |
| author_facet | Anıl Özen Metin Yılmaz Görkem Yiğit İsa Civelek Mehmet Ali Türkçü Ferit Çetinkaya Ertekin Utku Ünal Hakkı Zafer İşcan |
| author_sort | Anıl Özen |
| collection | DOAJ |
| description | Abstract Background To evaluate the value of Glasgow Aneurysm Score (GAS) in predicting long-term mortality and survival in patients who have undergone endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Methods A retrospective single-center study of 257 patients with non-ruptured AAA undergoing EVAR between January 2013 and 2021. GAS scores were compared between the survivors (group 1) and the long-term mortality (group 2) groups. Cox regression analysis was used to determine independent predictors of late mortality. Receiver operating characteristic curve (ROC) analysis was used to determine the optimum cut-off values of GAS values to determine the effect on late-mortality. Survival analysis was conducted using Kaplan-Meier. Results The study included 257 patients with a mean age of 69.75 ± 7.75 (46–92), who underwent EVAR due to AAA. Average follow up period was 18.98 ± 22.84 months (0–88). Fourty-five (17.8%) mortalities occured during long-term follow-up. A past medical history of cancer resulted in a 2.5 fold increase in risk of long-term mortality (OR: 2.52, 95% CI 1.10–5.76; p = 0.029). GAS values were higher in group 2 compared to group 1 (81.02 ± 10.33 vs. 73.73 ± 10.46; p < 0.001). The area under the ROC curve for GAS was 0.682 and the GAS cut-off value was 77.5 (specificity 64%, p < 0.001). The mortality rates in patients with GAS < 77.5 and GAS > 77.5 were: 12.8% and 24.8% respectively (p = 0.014). Every 10 point increase in GAS resulted in approximately a 2 fold increase in risk of long-term mortality (OR: 1.8, 95% CI 1.3–2.5; p < 0.001). Five year survival rates in patients with GAS < 77.5 and > 77.5 were 75.7% and 61.7%, respectively (p = 0.013). Conclusions The findings of our study suggests that an increase in GAS score may predict long-term mortality. In addition, the mortality rates in patients above the GAS cut-off value almost doubled compared to those below. Furthermore, the presence of a past history of cancer resulted in a 2.5 fold increase in long-term mortality risk. Addition of cancer to the GAS scoring system may be considered in future studies. Further studies are necessary to consolidate these findings. |
| first_indexed | 2024-12-13T16:58:15Z |
| format | Article |
| id | doaj.art-01f176db023d4667afb9b243d8b8d519 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-13T16:58:15Z |
| publishDate | 2021-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-01f176db023d4667afb9b243d8b8d5192022-12-21T23:37:52ZengBMCBMC Cardiovascular Disorders1471-22612021-11-012111810.1186/s12872-021-02366-yGlasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm?Anıl Özen0Metin Yılmaz1Görkem Yiğit2İsa Civelek3Mehmet Ali Türkçü4Ferit Çetinkaya5Ertekin Utku Ünal6Hakkı Zafer İşcan7Department of Cardiovascular Surgery, Ankara City HospitalDepartment of Cardiovascular Surgery, VM Medicalpark HospitalDepartment of Cardiovascular Surgery, Yozgat City HospitalDepartment of Cardiovascular Surgery, Ankara City HospitalDepartment of Cardiovascular Surgery, Ankara City HospitalDepartment of Cardiovascular Surgery, Ankara City HospitalDepartment of Cardiovascular Surgery, Hitit University Faculty of MedicineDepartment of Cardiovascular Surgery, Ankara City HospitalAbstract Background To evaluate the value of Glasgow Aneurysm Score (GAS) in predicting long-term mortality and survival in patients who have undergone endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Methods A retrospective single-center study of 257 patients with non-ruptured AAA undergoing EVAR between January 2013 and 2021. GAS scores were compared between the survivors (group 1) and the long-term mortality (group 2) groups. Cox regression analysis was used to determine independent predictors of late mortality. Receiver operating characteristic curve (ROC) analysis was used to determine the optimum cut-off values of GAS values to determine the effect on late-mortality. Survival analysis was conducted using Kaplan-Meier. Results The study included 257 patients with a mean age of 69.75 ± 7.75 (46–92), who underwent EVAR due to AAA. Average follow up period was 18.98 ± 22.84 months (0–88). Fourty-five (17.8%) mortalities occured during long-term follow-up. A past medical history of cancer resulted in a 2.5 fold increase in risk of long-term mortality (OR: 2.52, 95% CI 1.10–5.76; p = 0.029). GAS values were higher in group 2 compared to group 1 (81.02 ± 10.33 vs. 73.73 ± 10.46; p < 0.001). The area under the ROC curve for GAS was 0.682 and the GAS cut-off value was 77.5 (specificity 64%, p < 0.001). The mortality rates in patients with GAS < 77.5 and GAS > 77.5 were: 12.8% and 24.8% respectively (p = 0.014). Every 10 point increase in GAS resulted in approximately a 2 fold increase in risk of long-term mortality (OR: 1.8, 95% CI 1.3–2.5; p < 0.001). Five year survival rates in patients with GAS < 77.5 and > 77.5 were 75.7% and 61.7%, respectively (p = 0.013). Conclusions The findings of our study suggests that an increase in GAS score may predict long-term mortality. In addition, the mortality rates in patients above the GAS cut-off value almost doubled compared to those below. Furthermore, the presence of a past history of cancer resulted in a 2.5 fold increase in long-term mortality risk. Addition of cancer to the GAS scoring system may be considered in future studies. Further studies are necessary to consolidate these findings.https://doi.org/10.1186/s12872-021-02366-yEndovascularAortic aneurysmRisk assessmentAnalysisSurvivalMortality |
| spellingShingle | Anıl Özen Metin Yılmaz Görkem Yiğit İsa Civelek Mehmet Ali Türkçü Ferit Çetinkaya Ertekin Utku Ünal Hakkı Zafer İşcan Glasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm? BMC Cardiovascular Disorders Endovascular Aortic aneurysm Risk assessment Analysis Survival Mortality |
| title | Glasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm? |
| title_full | Glasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm? |
| title_fullStr | Glasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm? |
| title_full_unstemmed | Glasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm? |
| title_short | Glasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm? |
| title_sort | glasgow aneurysm score a predictor of long term mortality following endovascular repair of abdominal aortic aneurysm |
| topic | Endovascular Aortic aneurysm Risk assessment Analysis Survival Mortality |
| url | https://doi.org/10.1186/s12872-021-02366-y |
| work_keys_str_mv | AT anılozen glasgowaneurysmscoreapredictoroflongtermmortalityfollowingendovascularrepairofabdominalaorticaneurysm AT metinyılmaz glasgowaneurysmscoreapredictoroflongtermmortalityfollowingendovascularrepairofabdominalaorticaneurysm AT gorkemyigit glasgowaneurysmscoreapredictoroflongtermmortalityfollowingendovascularrepairofabdominalaorticaneurysm AT isacivelek glasgowaneurysmscoreapredictoroflongtermmortalityfollowingendovascularrepairofabdominalaorticaneurysm AT mehmetaliturkcu glasgowaneurysmscoreapredictoroflongtermmortalityfollowingendovascularrepairofabdominalaorticaneurysm AT feritcetinkaya glasgowaneurysmscoreapredictoroflongtermmortalityfollowingendovascularrepairofabdominalaorticaneurysm AT ertekinutkuunal glasgowaneurysmscoreapredictoroflongtermmortalityfollowingendovascularrepairofabdominalaorticaneurysm AT hakkızaferiscan glasgowaneurysmscoreapredictoroflongtermmortalityfollowingendovascularrepairofabdominalaorticaneurysm |