Vol.:(0123456789) 1 3 Surgery Today https://doi.org/10.1007/s00595-019-01805-w ORIGINAL ARTICLE Predicting mortality in patients admitted to the intensive care unit after open vascular surgery Pedro Reis 1,2  · Ana Isabel Lopes 1  · Diana Leite 1  · João Moreira 1  · Leonor Mendes 1  · Sofa Ferraz 1  · Tânia Amaral 1  · Fernando Abelha 1,2 Received: 17 July 2018 / Accepted: 23 March 2019 © Springer Nature Singapore Pte Ltd. 2019 Abstract Purposes Vascular surgery (VS) has a higher perioperative mortality than other types of surgery. We compared diferent scores for predicting mortality in patients admitted to the intensive care unit (ICU) after open VS. Methods Patients admitted to the ICU after open VS from 2006 to 2013 were included. We calculated the Acute Physiol- ogy and Chronic Health Evaluation (APACHE), Simplifed Acute Physiology Score (SAPS), Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) and Preoperative Score to Predict Postoperative Mortality (POSPOM). We performed multivariate logistic regression to assess independent factors with the calculation of odds ratios (ORs) and 95% confdence intervals (CIs). We tested the predictive ability of the scores using the area under the receiver operating characteristics curve (AUROC). Results A total of 833 consecutive patients were included. Hospital mortality was 5.1% (1.3% after intermediate-risk and 8.4% after high-risk surgery). In the multivariate analysis, the age (OR 1.04, 95% CI 1.01–1.08, p = 0.013), smoking status (OR 2.46, 95% CI 1.16–5.21, p = 0.019), surgery risk (OR 2.92, 95% CI 1.05–8.08, p = 0.040), serum sodium level (OR 1.17, 95% CI 1.10–1.26, p < 0.001), urea (OR 1.01, 95% CI 1.01–1.02, p = 0.001) and leukocyte count (OR 1.05, 95% CI 1.01–1.10, p = 0.009) at admission were considered independent predictors. Hematocrit (0.86, 95% CI 0.80–0.93, p < 0.001) was considered an independent protective factor. The AUROC of our model was 0.860, compared to SAPS (0.752), APACHE (0.774), POSPOM (0.798) and POSSUM (0.829). Conclusion The observed mortality was within the predicted range (1–5% after intermediate-risk and > 5% after high-risk surgery). POSSUM and POSPOM had slightly better predictive capacity than SAPS or APACHE. Keywords Hospital mortality · SAPS · APACHE · Intensive care unit · Vascular surgery * Pedro Reis pedrojreis@hotmail.com Ana Isabel Lopes analopes13@gmail.com Diana Leite dianaleite.a@gmail.com João Moreira joaopbmoreira@gmail.com Leonor Mendes leonor.cftmendes@gmail.com Sofa Ferraz soferraz@gmail.com Tânia Amaral taniaamaral22@gmail.com Fernando Abelha fernando.abelha@gmail.com 1 São João Hospital Centre, Alameda Prof Hernani Monteiro, 4200-319 Porto, Portugal 2 Faculdade de Medicina da Universidade do Porto, Alameda Prof Hernani Monteiro, 4200-319 Porto, Portugal