This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Systematic review of mortality risk prediction models in the era of endovascular abdominal aortic aneurysm surgery. BJS 2017; 104: 964-976.

Published: 13th June 2017

Authors: N. Lijftogt, T. W. F. Luijnenburg, A. C. Vahl, E. D. Wilschut, V. J. Leijdekkers, M. F. Fiocco et al.

Background

The introduction of endovascular aneurysm repair (EVAR) has reduced perioperative mortality after abdominal aortic aneurysm (AAA) surgery. The objective of this systematic review was to assess existing mortality risk prediction models, and identify which are most useful for patients undergoing AAA repair by either EVAR or open surgical repair.

Method

A systematic search of the literature was conducted for perioperative mortality risk prediction models for patients with AAA published since 2006. PRISMA guidelines were used; quality was appraised, and data were extracted and interpreted following the CHARMS guidelines.

Results

Some 3903 studies were identified, of which 27 were selected. A total of 13 risk prediction models have been developed and directly validated. Most models were based on a UK or US population. The best performing models regarding both applicability and discrimination were the perioperative British Aneurysm Repair score (C‐statistic 0·83) and the preoperative Vascular Biochemistry and Haematology Outcome Model (C‐statistic 0·85), but both lacked substantial external validation.

Conclusion

Mortality risk prediction in AAA surgery has been modelled extensively, but many of these models are weak methodologically and have highly variable performance across different populations. New models are unlikely to be helpful; instead case‐mix correction should be modelled and adapted to the population of interest using the relevant mortality predictors.

Full text

You may also be interested in

Original article

Sex differences in repair rates and outcomes of patients with ruptured abdominal aortic aneurysm. BJS 2019; 106: 1480-1487.

Authors: S. Zommorodi, M. Bottai, R. Hultgren

Original article

Observational study of the medical management of patients with peripheral artery disease.

Authors: A. Saratzis, N. E. M. Jaspers, B. Gwilym, O. Thomas, A. Tsui, R. Lefroy et al.

Original article

Predicting reamputation risk in patients undergoing lower extremity amputation due to the complications of peripheral artery disease and/or diabetes. BJS 2019; 106: 1026-1034.

Authors: J. M. Czerniecki, M. L. Thompson, A. J. Littman, E. J. Boyko, G. J. Landry, W. G. Henderson et al.

Original article

Health gains, costs and cost‐effectiveness of a population‐based screening programme for abdominal aortic aneurysms. BJS 2019; 106: 1043-1054.

Authors: N. Nair, G. Kvizhinadze, G. T. Jones, R. Rush, M. Khashram, J. Roake et al.

Original article

Development and validation of a gene expression test to identify hard‐to‐heal chronic venous leg ulcers. BJS 2019; 106: 1035-1042.

Authors: D. C. Bosanquet, A. J. Sanders, F. Ruge, J. Lane, C. A. Morris, W. G. Jiang et al.

Randomized clinical trial

Randomized clinical trial of endovenous laser ablation versus direct and indirect radiofrequency ablation for the treatment of great saphenous varicose veins. BJS 2019; 106: 998-1004.

Authors: S. A. S. Hamann, L. Timmer‐de Mik, W. M. Fritschy, G. R. R. Kuiters, T. E. C. Nijsten, R. R. Bos et al.

Systematic review

Meta‐analysis of the outcomes of treatment of internal carotid artery near occlusion. BJS 2019; 106: 665-671.

Authors: A. J. A. Meershoek, E. E. Vries, D. Veen, H. M. Ruijter, G. J. Borst, A. Garcia‐Pastor et al.

Original article

Contemporary prevalence of carotid stenosis in patients presenting with ischaemic stroke. BJS 2019; 106: 872-878.

Authors: S. F. Cheng, M. M. Brown, R. J. Simister, T. Richards

Original article

Baseline findings of the population‐based, randomized, multifaceted Danish cardiovascular screening trial (DANCAVAS) of men aged 65–74 years. BJS 2019; 106: 862-871.

Authors: J. S. Lindholt, L. M. Rasmussen, R. Søgaard, J. Lambrechtsen, F. H. Steffensen, L. Frost et al.

Randomized clinical trial

Randomized clinical trial of mechanochemical and endovenous thermal ablation of great saphenous varicose veins. BJS 2019; 106: 548-554.

Authors: S. Vähäaho, O. Mahmoud, K. Halmesmäki, A. Albäck, K. Noronen, P. Vikatmaa et al.

Systematic review

Meta‐analysis of long‐term survival after elective endovascular or open repair of abdominal aortic aneurysm. BJS 2019; 106: 523-533.

Authors: R. M. A. Bulder, E. Bastiaannet, J. F. Hamming, J. H. N. Lindeman

Original article

Mortality prediction following non‐traumatic amputation of the lower extremity. BJS 2019; 106: 879-888.

Authors: D. C. Norvell, M. L. Thompson, E. J. Boyko, G. Landry, A. J. Littman, W. G. Henderson et al.