Risk index scoreを用いた腹部大動脈瘤手術成績の検討

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  • A STUDY ON SURGICAL RESULTS OF ABDOMINAL AORTIC ANEURYSMS USING THE RISK INDEX SCORE

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Although for cases undergoing palliative surgery of abdominal aortic aneurysms (below: AAA), surgical replacement with a Y-shaped artificial blood vessel is an operation with a relatively high degree of safety, in recent years with the expansion of indications the elderly and high risk patients have tended to increase. Forty-six patients who underwent AAA palliative surgery at our faculty from 1978 through 1989 were classified them according to termination into 3 groups, namely, early death, late death and survival, and compared for age, maximum diameter of aneurysm, operating time, amount of blood loss and preoperative risk factors. In evaluating preoperative risk factors, we used a risk index score (below: RIS) by assigning points to 7 items (I. cardiac function, II. renal function, III. respiratory function, IV. cerebral vascular disorder, V. hypertension, VI. diabetes and VII. hyperlipidemia). Based on the results of this study on the propriety of this RIS, the following conclusions, could be obtained, (1) Among the 3 groups, a statistically significant difference was observed only in regard to RIS. (2) In comparing the survival rate of the 3 groups according to high (H), moderate (M) or low (L) RIS total scores, a significant difference after 3 years was observed between the H group and the other 2 groups, L and M. (3) All cases of early death had high RIS scores. (4) This RIS is considered to be appropriate as an objective evaluation method of high risk.

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