[Scoring in abdominal aortic aneurysm surgery--evaluation of the SVS / AAVS Comorbidity Severity Score]

Decision making in abdominal aortic aneurysm repair due to open or endovascular procedure is associated to the natural course of disease and to the peri-operative mortality. Risk evaluation by scoring systems is essential for the choice of individual therapy. Aim of the presented study was to examine the SVS / AAVS Comorbidity Severity Score of the "Society for Vascular Surgery" (SVS) / "American Association for Vascular Surgery".

The Comorbidity Severity Score was applied to 328 patients undergoing abdominal aortic aneurysm repair. Additionally, comparison was made to the classification of "American Society of Anaesthesiologists Physical Status Classification Scale" (ASA classes 1-5), and the "Eagle's Vascular Surgery Low Risk Clinical Markers". The scorings were correlated to the mortality and the time of hospitalisation.

Patients with electively performed open repair (n = 168) showed an Comorbidity Severity Score of 6.8 +/- 3.9, ASA-Score of 2.7 +/- 0.6, and Eagle-Score of 1.04 +/- 0.9. In elective endovascular repair (n = 78) corresponding scorings were 11.6 +/- 5.0 (p < 0.05), 2.9 +/- 0.5 (n. s.), and 1.7 +/- 1.0 (n. s). Patients with elective open repair stayed significantly longer at hospital (11.1 +/- 9.2 versus 8.1 +/- 6.9 days). Mortality was 2.4 percent and 5.1 percent (p = 0.02).

The newly developed SVS / AAVS Comorbidity Severity Score demonstrated the high risk profile of the endovascularly treated patients with abdominal aortic aneurysms as well as the older scorings systems do. But there was no correlation demonstrable to mortality or to duration of hospitalisation.