EVAR'ın Maliyet Etkinliğini Öngörmede Siena ve St George Vascular Institute Risk Skorlama Sistemleri

Abstract

Objectives: Endovascular aneurysm repair (EVAR) is a widely used modality in the treatment of abdominal aortic aneurysms (AAA). Siena EVAR and St.George Vascular Institute (SGVI) scores are risk scores to predict possible EVAR related reinterventions. This study was aimed to validate the risk scores and compare the predictivity of the scoring systems for hospital cost-effectiveness in our population.Materials and Methods: 39 patients with unruptured infrarenal AAA, including both elective and non-elective admissions which had a follow-up period from at least 6 months are included in our study. Siena EVAR score and SGVI score are calculated. The relation of the complications (adjuncts at the index operation, reinterventions during follow up), costs (index procedure and overall), aneurysm related mortality are compared among the risk groups. Results: In our study, SGVI score had a predictivity among high and low-risk groups involving reinterventions during follow up, cost on index operation and mortality (P < 0.05). Siena EVAR score had no significant predictivity (p > 0.05). Conclusion: A high-risk value in SGVI score must warn the surgeon to reassess the treatment option for AAA. If EVAR is indicated the health care providers and assurance system can count on a higher cost on index operation, a higher risk of reintervention and mortality during long term follow up.