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Master Thesis

Élaboration d’un score pronostique de mortalité pour les patients admis pour complication aiguë d’anévrisme de l’aorte abdominale

Abstract : Introduction. Hight mortality rates are observed following acute complications of abdominal aortic aneurysms. The aim of this study was to create a simple prognostic score based on the pre-operative data to define which patients would not benefit from a surgical procedure. Method. We retrospectively and prospectively collected the pre- and postoperative data of all patients admitted to the emergency critical care department of the Bordeaux University Hospital for a symptomatic unruptured or a ruptured aneurysm between september 2015 and february 2019. Results. 95 patients were included of which 27 died for an in-hospital mortality rate of 28.4%. The following variables were selected for the TOUCAN-score: pre-operative norepinephrine use, pre-operative transfusion, transrenal aneurysm, pH <7.35, TP <75%, age> 76 years. The area under the curve (AUC) ROC was 0.81. A threshold greater than or equal to 3/6 was chosen for a specificity of 97.1% and a sensitivity of 44.4%. The 7 studied scores of the literature had lower AUC than our score. Conclusion. A TOUCAN-score ≥ 3, because of its high specificity, makes it possible to define preoperatively which patients would not benefit from a surgical intervention, helping medical decision. On the other hand, a score <3 does not allow to conclude on the prognosis of these patients.
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Jonathan Naudin. Élaboration d’un score pronostique de mortalité pour les patients admis pour complication aiguë d’anévrisme de l’aorte abdominale. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02498301⟩

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