Risk Score of Mousa et al for a Patient Undergoing Elective Endovascular Abdominal Aortic Aneurysm Repair (EVAR)

Description

Mousa et al developed a risk score for long-term (5 and 10 year) mortality after an elective endovascular abdominal aortic aneurysm repair (EVAR). This can help to identify a patient who may benefit from the procedure. The authors are from West Virginia University.

The score is a modification of the model reported by De Martino et al.

Patient selection: elective endovascular repair of an abdominal aortic aneurysm (average age 73.6 years; 82% male; 86% with smoking history)

Parameters:

(1) body mass index (BMI) in kg per square meter

(2) diameter of the aneurysm in cm

(3) renal function (eGFR units not stated, presumed mL per min per 1.73 sq m)

(4) age in years

(5) home oxygen for COPD

(6) unstable angina

(7) fitness for open surgery

Parameter	Finding	Points
BMI	< 25 kg per sq m	1
	25 to 35 kg per sq m	0
	> 35 kg per sq m	1
diameter of aneurysm	<= 5.8 cm	0
	> 5.8 cm	1
renal function	eGFR >= 60	0
	eGFR 30 to 59	1
	eGFR < 30	2
	on dialysis	3
age in years	< 75 years	0
	75 to 79 years	2
	>= 80 years	3
home oxygen	no	0
	yes	3
unstable angina	no	0
	yes	3
ftiness for surgery	fit	0
	unfit	1

where:

• Dialysis and eGFR were scored once based on Table 4 page 265.

total score =

= SUM(points for all 7 items)

Interpretation:

• minimum score: 0

• maximum score: 15

• The higher the score the worse the survival.

• Aspirin therapy was protective. The absence of aspirin therapy increased risk with hazard ratio of 1.3 which would translate to 1 point (Table 4, page 265). This was not included in the score.

Score	Risk Group	5-Year Survival	10-Year Survival
0 to 2	low	89%	77%
3 or 4	medium	81%	60%
5 to 15	high	77%	40%

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Risk Score of Mousa et al for a Patient Undergoing Elective Endovascular Abdominal Aortic Aneurysm Repair (EVAR)

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