RISK STRATIFICATION IN SELECTIVE SURGERY OF ABDOMINAL AORTIC ANEURYSM

• Main Authors: N. A. Yaitsky, A. Ya. Bedrov, A. A. Moiseev, I. V. Nesterova
• Format: Article
• Language: Russian
• Published: Pavlov First Saint Petersburg State Medical University 2018-01-01
• Series: Вестник хирургии имени И.И. Грекова
• Subjects: abdominal aortic aneurysm; complications; risk; аневризма инфраренального сегмента аорты; ранние послеоперационные осложнения; прогнозирование риска
• Online Access: https://www.vestnik-grekova.ru/jour/article/view/469

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.