Glasgow Aneurysm Score predicts survival after endovascular stenting of abdominal aortic aneurysm in patients from the EUROSTAR registry

Background: The aim of the present study was to evaluate the efficacy of the Glasgow Aneurysm Score (GAS) in predicting the survival of 5498 patients who underwent endovascular repair (EVAR) of an abdominal aortic aneurysm (AAA) and were enrolled in the EUROpean collaborators on Stent-graft Techniques for abdominal aortic Aneurysm Repair (EUROSTAR) Registry between October 1996 and March 2005. Methods: The GAS was calculated in patients who underwent EVAR and was correlated to outcome measurements. Results: The median GAS was 78(.)8 (interquartile range 71(.)9-86(.)4, mean 79(.)2). Tertile 30-day mortality rates were 1(.)1 per cent for patients with a GAS less than 74(.)4, 2(.)1 per cent for those with a score between 74.4 and 83(.)6, and 5(.)3 per cent for patients with a score over 83.6 (P < 0.001). Multivariate analysis showed that GAS was an independent predictor of postoperative death (P < 0.001). The receiver-operator characteristic curve showed that the GAS had an area under the curve of 0(.)70 (95 per cent confidence interval 0(.)66 to 0(.)74; s.e. 0(.)02; P < 0.001) for predicting immediate postoperative death. At its best cut-off value of 86(.)6, it had a sensitivity of 56(.)1 per cent, specificity 76(.)2 per cent and accuracy 75(.)6 per cent. Multivariable analysis showed that overall survival was significantly different among the tertiles of the GAS (P < 0.001). Conclusion: The GAS was effective in predicting outcome after EVAR. Because its efficacy has also been shown in patients undergoing open repair of AAA, it can be used to aid decisions about treatment in all patients with an AAA.