Objective: To examine association of presenting clinical acuity and Glasgow Aneurysm Score (GAS) with perioperative and 1-year mortality.
Design: Retrospective chart review.
Setting: Major tertiary care facility.
Participants: Patients with ruptured abdominal aortic aneurysm (rAAA) from 2003 through 2013.
Interventions: Emergency repair of rAAA.
Measurements And Main Results: The authors reviewed outcomes after stable versus unstable presentation and by GAS. Unstable presentation included hypotension, cardiac arrest, loss of consciousness, and preoperative tracheal intubation. In total, 125 patients (40 stable) underwent repair. Perioperative mortality rates were 41% and 12% in unstable and stable patients, respectively (p<0.001). Unstable status had 88% sensitivity and 41% specificity for predicting perioperative mortality. Using logistic regression, higher GAS was associated with perioperative mortality (p<0.001). Using receiver operating characteristic analysis, the area under the curve was 0.72 (95% CI, 0.62-0.82) and cutoff GAS≥96 had 63% and 72% sensitivity and specificity, respectively. Perioperative mortality for GAS≥96 was 51% (25/49), whereas it was 20% (15/76) for GAS≤95. The estimated 1-year survival (95% CI) was 75% (62%-91%) for stable patients and 48% (38%-60%) for unstable patients. Estimated 1-year survival (95% CI) was 23% (13%-40%) for GAS≥96 and 77% (67%-87%) for GAS≤95.
Conclusions: Clinical presentation and GAS identified patients with rAAA who were likely to have a poor surgical outcome. GAS≥96 was associated with poor long-term survival, but>20% of these patients survived 1 year. Thus, neither clinical presentation nor GAS provided reliable guidance for decisions regarding futility of surgery.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1053/j.jvca.2015.10.019 | DOI Listing |
Cureus
November 2024
Radiology, Epsom and St Helier NHS Trust, London, GBR.
Subcapsular liver haematoma in pregnancy, a rare and life-threatening condition, is more commonly associated with severe preeclampsia and haemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. The common presenting symptom of subcapsular haematoma is acute-onset upper abdominal pain in patients suffering from preeclampsia; shock is the presenting feature in severe cases of rupture. Here we have discussed a case of subcapsular haematoma associated with HELLP syndrome in a patient who responded to conservative management.
View Article and Find Full Text PDFCase Rep Womens Health
December 2024
Médecins Sans Frontières-Belgique (OCB), Avenue 7 Février, Grande passe, Port-à-Piment, Haïti.
Uterine rupture is a well-known, life-threatening complication of misoprostol use; the incidence is remarkably low. Herein, we report what seems to be the first documented case of uterine rupture following induction of labour for intrauterine foetal death in the second trimester without a uterine scar. A 40-year-old woman with no history of caesarean section or uterine surgery presented with mild lower abdominal pain and mild genital bleeding.
View Article and Find Full Text PDFJ Vasc Surg
December 2024
Columbia University Irving Medical Center, Division of Vascular Surgery and Endovascular Interventions, New York, NY. Electronic address:
Objective: Single-center studies have suggested that solid organ transplant recipients are at increased risk for arterial aneurysms. Moreover, they describe a more aggressive natural history with increased rates of expansion and rupture. In this exploratory analysis, we aim to assess the frequency of arterial aneurysms in solid organ transplant recipients using a large-scale national database.
View Article and Find Full Text PDFProc (Bayl Univ Med Cent)
October 2024
Department of Gastroenterology and Hepatology, The University of Florida College of Medicine - Jacksonville, Jacksonville, Florida, USA.
Background: Endoscopic bariatric interventions are viable alternatives to traditional weight loss surgeries for patients with a body mass index between 30 and 40 kg/m. While studies have explored the impact of intragastric balloons on obesity and weight reduction, comprehensive data on real-world device-related complications and failures are limited. This study aimed to investigate mechanical failures leading to patient adverse events reported to the US Food and Drug Administration.
View Article and Find Full Text PDFPan Afr Med J
December 2024
Department of Visceral Surgery, Fattouma Bourguiba Hospital, Monastir University, Monastir, Tunisia.
The intrauterine device (IUD) is a widely utilized contraceptive method. In cases of uterine rupture, an IUD can migrate to the intra-abdominal or pelvic cavity, leading to various complications such as gastrointestinal perforation. The aim of this study was to report a case of a 29-year-old woman presented with acute left lumber pain.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!