title: Role of the Hardman index in predicting mortality for open and endovascular repair of ruptured abdominal aortic aneurysm.
abstract: OBJECTIVE
  To correlate the Hardman prognostic index with perioperative mortality in patients undergoing open and endovascular repair of ruptured abdominal aortic aneurysm (rAAA).
  
  
  METHODS
  Over a 5-year period, 126 patients (109 men; mean age 74 years, range 51-91) underwent open (n=74) or endovascular (n=52) repair of rAAA in a single unit. Five Hardman factors (age>76 years, history of loss of consciousness, ECG evidence of ischemia, hemoglobin<9.0 g/dL, and serum creatinine>0.19 mmol/L) were assessed, and their association with in-hospital or 30-day mortality was evaluated retrospectively by chi-square or logistic regression analysis.
  
  
  RESULTS
  The mortality for open repair was 51.4% (38/74) in comparison to 32.7% (17/52) for the endovascular group (p=0.05). On multivariate analysis, loss of consciousness (p=0.03, OR 2.9, 95% CI 1.1 to 7.5) was the only significant predictor of mortality in both groups. The mortality rates for open repair patients with Hardman scores<2 were 43.5% (20/46) in comparison to 22.9% (8/35) for the endovascular group (p=0.06), whereas mortality rates for patients with scores>or=2 were 64.3% (18/28) and 52.9% (9/17) for the respective groups (p=0.54).
  
  
  CONCLUSIONS
  The Hardman index correlates well with mortality in both the open and endovascular groups. Those with a score<2 have a trend toward better survival following endovascular repair compared to open repair, while this benefit is not obvious in patients with a score>or=2.
authors: Department of Vascular and Endovascular Surgery, Belfast City Hospital, Northern Ireland, UK. aneessharif@yahoo.co.uk
authors: Muhammad Anees
authors: MA
authors: Sharif
authors: Bernard
authors: B
authors: Lee
authors: Ragai Reda
authors: RR
authors: Makar
authors: William
authors: W
authors: Loan
authors: Chee Voon
authors: CV
authors: Soong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality* / Q000601:surgery*; D001019:Aortic Rupture / Q000401:mortality* / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods / Q000401:mortality*; D019992:Databases as Topic; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015203:Reproducibility of Results; D012107:Research Design; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome