The Glasgow @entity439 Score does not predict mortality after open @entity1028 in the era of XXXX repair.

@entity1 @entity439 @entity1028
OBJECTIVE: @entity439 repair (EVAR) has reduced early adverse outcomes from @entity1028 ( @entity1028 ) repair. Preferential use of EVAR may have altered the profile of @entity1 who undergo open repair. The validity of scoring systems such as the Glasgow @entity439 Score (GAS), devised when open surgery was the only treatment, required reappraisal. METHODS: @entity1 were identified from a database of @entity1 undergoing elective infrarenal aneurysm repair at seven United Kingdom centers, and the GAS was calculated for each @entity1 . Discrimination and calibration were calculated to determine the performance of the model in this setting using the C statistic, tertile analysis, and the   (2) test. Univariate analysis was performed to determine if a new iteration of the GAS could be produced. RESULTS: We identified 330 @entity1 who met the inclusion criteria. There were 18 deaths  <=30 days of surgery (5.4%). The average (standard deviation) GAS was 78.6 (8.8) for the survivors and 81.9 (10.4) for nonsurvivors (P = .122). The C statistic was 0.625 (95% confidence interval, 0.481-0.769; P = .75) suggesting a discriminatory ability not much better than chance alone. Despite this, calibration of the model was good. There was no significant difference in the comorbidities of either group, so no recalibration of the GAS could be performed. CONCLUSION: The GAS did not discriminate between survivors and nonsurvivors after open @entity1028 repair in this cohort. In the era of EVAR, it is possible that the GAS does not predict the outcome of open @entity1028 repair. An alternative explanation is that @entity1 with risk factors for poor outcomes from EVAR, such as adverse @entity1028 morphology, are being selected out for open repair.
