Papers Presented at the Twenty-ninth Annual Meeting of the Peripheral Vascular Surgery Society Risk-Adjusted Analysis of Outcomes Following Elective Open Abdominal Aortic Aneurysm Repair

摘要: The purpose of this study was to describe a method analyze outcomes following open abdominal aortic aneurysm (AAA) repair while considering the variability in patients’ preoperative risk. Consecutive patients undergoing elective infrarenal AAA during 4-year period (2000-2003) were reviewed. Thirty-day or in-hospital mortality major outcome variable. Preoperative risk estimated for each patient using validated scoring system that considers age, renal dysfunction, and coronary artery cerebrovascular disease. A risk-adjusted cumulative sum used compare observed versus predicted by assigning score, based on log-likelihood ratios, patient. These scores sequentially plotted with preset control limits allow “signaling” when results substantially different than expected (doubling halving odds ratios). Four hundred sixty-three studied an overall early rate 4.5% (n = 21). Patients allocated three groups (low, n 89; medium, 160; high, 214) according medical comorbidity-based system. Predicted (P) (0) rates group as follows: low, 2.4% 2.2% (0); 4.1% 4.4% 9.3% 5.6% (0). resulting riskadjusted sequentially. This plot flat first year then adopted negative slope crossing lower limit after 266 patients, indicating improved compared those expected. coincided adoption routine intraoperative cell saver use our practice. form analysis allows prospective evaluation patient-mix variabilities.