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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
Italian Journal of Vascular and Endovascular Surgery 2009 Settembre;16(3):187-91
Prognostic scoring in ruptured abdominal aortic aneurysm
Juvonen T., Biancari F.
Division of Cardio-thoracic and Vascular Surgery, Department of Surgery, Oulu University Hospital, Oulu, Finland
During the last 15 years, several studies have focused their attention on the development and validation of risk scoring systems for a reliable quantification of the operative risk of patients with ruptured abdominal aortic aneurysm (RAAA). This article briefly summarizes the principles for developing such risk scoring systems, their criteria and reliability as well as future perspectives on this issue. According to the current data, the Glasgow Aneurysm Score and the Hardman’ score are the most accurate in predicting the immediate outcome of patients with RAAA. However, a number of studies did not confirm their predictive value. Importantly, they have been derived more than one decade ago, and meanwhile major changes in the referral pathway, diagnostic approach as well as in the operative techniques and anesthesiological methods have occurred. Since we are in need of an instrument to quantify the operative risk in patients undergoing repair of RAAA in centers with such different referral pathways, volume and experience, and techniques of aneurysm repair, a multicenter international registry should be organized in order to get enough data and derive a specific and accurate RSS to estimate the operative risk of the increasing number of patients with RAAA.