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, Serment d'Hippocrate

, Au moment d'être admis à exercer la médecine, je promets et je jure d'être fidèle aux lois de l'honneur et de la probité

, Mon premier souci sera de rétablir, de préserver ou de promouvoir la santé dans tous ses éléments, physiques et mentaux, individuels et sociaux

, Je respecterai toutes les personnes, leur autonomie et leur volonté, sans aucune discrimination selon leur état ou leurs convictions. J'interviendrai pour les protéger si elles sont affaiblies, vulnérables ou menacées dans leur intégrité ou leur dignité. Même sous la contrainte

, Admis dans l'intimité des personnes, je tairai les secrets qui me seront confiés

, J'apporterai mon aide à mes confrères ainsi qu'à leurs familles dans l'adversité

, Que les hommes et mes confrères m'accordent leur estime si je suis fidèle à mes promesses

, Introduction Les complications aiguës des anévrismes de l'aorte abdominale sont grevées d'une mortalité élevée

, Méthode Nous avons recueilli de façon rétrospective puis prospective les données pré, per et post-opératoires de tous les patients admis dans le service de réanimation des urgences du CHU de Bordeaux pour une complication aiguë d'anévrisme de l'aorte abdominale par fissuration, dissection ou rupture entre septembre 2015 et février 2019. Résultats 95 patients ont été inclus, 27 sont décédés soit un taux de mortalité intrahospitalière de 28,4%. Les variables suivantes ont été sélectionnées pour le TOUCAN-score : noradrénaline préopératoire, transfusion pré-opératoire, anévrisme transrénal, pH< 7,35, TP < 75%, âge> 76 ans. L'aire sous la courbe (ASC) ROC était de 0,81. Un seuil supérieur ou égal à 3/6 a été retenu pour une spécificité de 97,1% et une sensibilité de 44, L'objectif de cette étude était de créer un score pronostic simple basé sur les données pré-opératoires permettant de déterminer quels sont les patients dont les caractéristiques ne permettent pas d'espérer un bénéfice chirurgical sur leur pronostic

, Conclusion Un TOUCAN-score ? 3, du fait de sa spécificité élevée, permet de déterminer en pré-opératoire quels sont les patients qui ne bénéficieront pas d'une intervention chirurgicale et constitue une aide à la décision en urgence

, Development of a mortality score for patients admitted for acute complication of abdominal aortic aneurysm 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, 2015.

, 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, Results 95 patients were included of which 27 died for an in-hospital mortality rate of 28.4%

, Mots clés : anévrisme, aorte abdominale, complication aiguë, rompu, fissuré, score pronostique, mortalité Discipline : Anesthésie-Réanimation UFR des Sciences Médicales, 146 Rue Léo Saignat, p.33076