{"id":{"repo_id":"edinburgh","oai_identifier":"oai:era.ed.ac.uk:1842/29391"},"canonical_url":"https://search.dev.ndltd.org/etd/edinburgh/oai:era.ed.ac.uk:1842/29391","repository":{"repo_id":"edinburgh","name":"University of Edinburgh","base_url":"https://era.ed.ac.uk/server/oai/request"},"display":{"title":"Prediction of outcome after abdominal aortic aneurysm rupture","abstract":"This thesis aims to examine the validity of existing tools recommended for outcome prediction after abdominal aortic aneurysm (AAA) rupture and to design and validate a novel risk scoring instrument. It also aims to examine the utility of novel predictive variables. Finally, it examines the functional outcomes achieved by survivors of aneurysm rupture.","abstract_html":"This thesis aims to examine the validity of existing tools recommended for outcome prediction after abdominal aortic aneurysm (AAA) rupture and to design and validate a novel risk scoring instrument. It also aims to examine the utility of novel predictive variables. Finally, it examines the functional outcomes achieved by survivors of aneurysm rupture.","abstract_has_math":false,"creators":["Tambyraja, Andrew Laksman"],"institution":"The University of Edinburgh","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2009,"date_issued":"2009","date_published":"2009","updated_at":"2026-07-24T02:14:14Z","subjects":[],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/1842/29391","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:creator","label":"Author","values":["Tambyraja, Andrew Laksman"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2018-03-29T12:20:35Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2018-03-29T12:20:35Z"]},{"key":"dc:date.issued","label":"Date","values":["2009"]},{"key":"dc:publisher","label":"Institution","values":["The University of Edinburgh"]},{"key":"dc:relation.isreferencedby","label":"Dc Relation Isreferencedby","values":["Already catalogued"]},{"key":"dc:type","label":"Dc Type","values":["Thesis or Dissertation"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["Doctoral"]},{"key":"dc:type.qualificationname","label":"Dc Type Qualificationname","values":["MD Doctor of Medicine"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/1842/29391"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["This thesis aims to examine the validity of existing tools recommended for outcome prediction after abdominal aortic aneurysm (AAA) rupture and to design and validate a novel risk scoring instrument. It also aims to examine the utility of novel predictive variables. Finally, it examines the functional outcomes achieved by survivors of aneurysm rupture.","Existing risk models and predictive variables for outcome were validated on a retrospective cohort of consecutive patients with ruptured AAA. These data were also used to design a novel prognostic index for outcome prediction. A prospective cohort of consecutive patients was used to further validate these scoring systems, examine novel prognostic variables and determine functional outcome.","Existing risk scoring instruments for patients with ruptured AAA lack validity. Analysis of preoperative variables in patients with ruptured AAA shows that absolute surgical futility cannot be predicted. However, in-hospital hypotension (<90mmHg), reduced Glasgow Coma Scale (<15) and anaemia (<9g/dL) are associated with perioperative death. When these risk factors are equally weighted and combined to create a novel risk scoring instrument (Edinburgh Ruptured Aneurysm Score-ERAS), three discriminatory tiers of risk are demonstrable. The validity of this risk instrument is confirmed on prospective data. Examination of novel perioperative prognostic variables shows that elevated cardiac troponin I, with or without clinically apparent cardiac dysfunction, is predictive of death after ruptured AAA repair. However, although ruptured AAA are associated with an early elevation in inflammatory biomarkers, these do not appear to confer additional prognostic value. Furthermore, for the first time, prospective study shows that patients who survive ruptured AAA repair achieve a good recovery in terms of functional outcome within six months of operation.","Surgical futility cannot be predicted prior to operation in patients with AAA. However, the ERAS shows potential as a preoperative prognostic index in patients with ruptured AAA."]},{"key":"dc:title","label":"Title","values":["Prediction of outcome after abdominal aortic aneurysm rupture"]}]}],"canonical_facts":{"dc:creator":["Tambyraja, Andrew Laksman"],"dc:date.accessioned":["2018-03-29T12:20:35Z"],"dc:date.available":["2018-03-29T12:20:35Z"],"dc:date.issued":["2009"],"dc:description.abstract":["This thesis aims to examine the validity of existing tools recommended for outcome prediction after abdominal aortic aneurysm (AAA) rupture and to design and validate a novel risk scoring instrument. It also aims to examine the utility of novel predictive variables. Finally, it examines the functional outcomes achieved by survivors of aneurysm rupture.","Existing risk models and predictive variables for outcome were validated on a retrospective cohort of consecutive patients with ruptured AAA. These data were also used to design a novel prognostic index for outcome prediction. A prospective cohort of consecutive patients was used to further validate these scoring systems, examine novel prognostic variables and determine functional outcome.","Existing risk scoring instruments for patients with ruptured AAA lack validity. Analysis of preoperative variables in patients with ruptured AAA shows that absolute surgical futility cannot be predicted. However, in-hospital hypotension (<90mmHg), reduced Glasgow Coma Scale (<15) and anaemia (<9g/dL) are associated with perioperative death. When these risk factors are equally weighted and combined to create a novel risk scoring instrument (Edinburgh Ruptured Aneurysm Score-ERAS), three discriminatory tiers of risk are demonstrable. The validity of this risk instrument is confirmed on prospective data. Examination of novel perioperative prognostic variables shows that elevated cardiac troponin I, with or without clinically apparent cardiac dysfunction, is predictive of death after ruptured AAA repair. However, although ruptured AAA are associated with an early elevation in inflammatory biomarkers, these do not appear to confer additional prognostic value. Furthermore, for the first time, prospective study shows that patients who survive ruptured AAA repair achieve a good recovery in terms of functional outcome within six months of operation.","Surgical futility cannot be predicted prior to operation in patients with AAA. However, the ERAS shows potential as a preoperative prognostic index in patients with ruptured AAA."],"dc:identifier.uri":["http://hdl.handle.net/1842/29391"],"dc:publisher":["The University of Edinburgh"],"dc:relation.isreferencedby":["Already catalogued"],"dc:title":["Prediction of outcome after abdominal aortic aneurysm rupture"],"dc:type":["Thesis or Dissertation"],"dc:type.qualificationlevel":["Doctoral"],"dc:type.qualificationname":["MD Doctor of Medicine"]},"updated_at":"2026-07-24T02:14:14Z"}