Glasgow aneurysm score predicts the outcome after emergency open repair of symptomatic, unruptured abdominal aortic aneurysms

Objective. To determine the predictor factors of in-hospital postoperative mortality in patients presenting with symptomatic but not ruptured abdominal aortic aneurysm (AAA) at our institution. Patients and methods. Forty-two patients who underwent urgent open repair for symptomatic, non-ruptured AAA were evaluated retrospectively. Results. Five patients (11.9%) died during the in-hospital stay. History of coronary artery disease (p = 0.014), cerebrovascular diseases (p = 0.015), renal failure according to Glasgow Aneurysm Score (GAS) criteria (p = 0.001), serum creatinine concentration (P = 0.026), and the GAS (p = 0.008) were predictive of postoperative death. The ROC curve analysis showed that the Glasgow Aneurysm Score had an area under the curve of 0.870 (95%C.I. 0.71-1, S.E. 0.08, p = 0.008), and its best cut-off value in predicting postoperative death was 90.0 (specificity 89.2%, sensitivity 80.0%). The postoperative mortality rate of patients with a Glasgow Aneurysm Score below 90 was 2.9%, whereas it was 50% for those with a score >= 90 (p = 0.003, O.R. 33.0). Conclusion. This study shows that the Glasgow Aneurysm Score is a good predictor of postoperative mortality and morbidity after urgent repair of symptomatic, non-ruptured AAA and can be useful in identifying those patients whose operative risk is prohibitive. Its simplicity makes it a clinically important-tool, particularly, in the emergency setting. Patients having a score less than 90 can safely undergo urgent open repair. Thorough evaluation and improvement of pre-operative status followed preferably by an endovascular repair is indicated for those with a score >= 90.