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...

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Autores principales:	Anıl Özen, Metin Yılmaz, Görkem Yiğit, İsa Civelek, Mehmet Ali Türkçü, Ferit Çetinkaya, Ertekin Utku Ünal, Hakkı Zafer İşcan
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Endovascular Aortic aneurysm Risk assessment Analysis Survival Mortality Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/01f176db023d4667afb9b243d8b8d519
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spelling	oai:doaj.org-article:01f176db023d4667afb9b243d8b8d5192021-11-21T12:04:04ZGlasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm?10.1186/s12872-021-02366-y1471-2261https://doaj.org/article/01f176db023d4667afb9b243d8b8d5192021-11-01T00:00:00Zhttps://doi.org/10.1186/s12872-021-02366-yhttps://doaj.org/toc/1471-2261Abstract 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.Anıl ÖzenMetin YılmazGörkem Yiğitİsa CivelekMehmet Ali TürkçüFerit ÇetinkayaErtekin Utku ÜnalHakkı Zafer İşcanBMCarticleEndovascularAortic aneurysmRisk assessmentAnalysisSurvivalMortalityDiseases of the circulatory (Cardiovascular) systemRC666-701ENBMC Cardiovascular Disorders, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Endovascular Aortic aneurysm Risk assessment Analysis Survival Mortality Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Endovascular Aortic aneurysm Risk assessment Analysis Survival Mortality Diseases of the circulatory (Cardiovascular) system RC666-701 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?
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.
format	article
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
title	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_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_sort	glasgow aneurysm score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm?
publisher	BMC
publishDate	2021
url	https://doaj.org/article/01f176db023d4667afb9b243d8b8d519
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Glasgow Aneurysm Score: a predictor of long-term mortality following endovascular repair of abdominal aortic aneurysm?

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