Performance of the AUB-HAS2 Cardiovascular Risk Index in vascular surgery patients. (October 2021)

• Record Type: Journal Article
• Authors: Msheik, Ahmad; Kaspar, Chris; Mailhac, Aurelie; Hoballah, Jamal J; Tamim, Hani; Dakik, Habib A
• Is Part Of: Vascular medicine. Volume 26:Number 5(2021)
• Page Start: 535
• Page End: 541
• Publication Date: 2021-10
• Subjects: AUB-HAS2 index -- preoperative cardiovascular evaluation -- vascular surgery -- risk assessment; Blood-vessels -- Diseases -- Periodicals; Peripheral vascular diseases -- Periodicals; Vascular Diseases -- Periodicals; Vaisseaux sanguins -- Maladies -- Périodiques; Maladies vasculaires périphériques -- Périodiques; 616.13
• DOI: 10.1177/1358863X21996806
• Languages: English
• ISSNs: 1358-863X

Abstract

The American University of Beirut (AUB)-HAS2 risk index is a recently published tool for preoperative cardiovascular evaluation. It is based on six data elements: history ofH eart disease, symptoms ofH eart disease (angina or dyspnea), A ge ⩾ 75 years, A nemia (hemoglobin < 12 mg/dL), emergencyS urgery, and vascularS urgery. This study analyzes the performance of a modified AUB-HAS2 index (excluding the vascular surgery element) in a broad spectrum of vascular surgery procedures. The study population consisted of 90, 476 vascular surgeries registered in the American College of Surgeons National Surgical Quality Improvement Program database. The performance of the AUB-HAS2 index was studied in seven groups: carotid endarterectomy (CEA), open abdominal aortic aneurysm surgical repair (OAAA), endovascular aortic aneurysm repair, supra-inguinal bypass, infra-inguinal bypass, lower extremity thrombo-endarterectomy, and lower extremity angioplasty. The outcome measure was death, myocardial infarction, or stroke at 30 days after surgery. Each patient was given an AUB-HAS2 score of 0, 1, 2, or > 2 depending on the number of data elements s/he has. The AUB-HAS2 index was able to stratify risk in the majority of patients into low (< 3%, score 0), intermediate (3–10%, score 1–2), and high (> 10%, score > 2) ( p < 0.0001). The receiver operating curve had an area of 0.71 in the overall group and it ranged from 0.60 in CEA patients to 0.75 in OAAA patients. In conclusion, the AUB-HAS2 index is a simple tool that can quickly and effectively stratify the risk of patients undergoing a broad spectrum of vascular surgeries into low, intermediate, and high.