title: Use of the Hardman index in predicting mortality in endovascular repair of ruptured abdominal aortic aneurysms.
abstract: OBJECTIVE
  The Hardman index is a predictor of 30-day mortality after open ruptured abdominal aneurysm repair through the use of preoperative patient factors. The aim of this study was to assess the Hardman index in patients undergoing endovascular repair of ruptured aortic aneurysms.
  
  
  METHODS
  A retrospective analysis of 95 patients undergoing emergency endovascular repairs of computed tomography-confirmed ruptured aneurysms from 1994 to 2008 in a university hospital was performed. All relevant patient variables, calculations of the Hardman index, and the incidence of 30-day mortality were collected in these patients. Correlation of the relationship between each variable and the overall score with the incidence of 30-day mortality was undertaken.
  
  
  RESULTS
  The 24-hour mortality was 16% and 30-day mortality 36%. Increasing scores on the Hardman index showed an increasing mortality rate. Thirty-day mortality in patients with a score of 0 to 2 was 30.5%, and in those with a score of ≥3 was 69.2% (P = .01, risk ratio = 2.26, 95% confidence interval = 0.98 to 5.17). This is lower than predicted in both patient groups based on Hardman index score. Loss of consciousness was the only statistically significant independent predictor of 30-day mortality with a risk ratio of 3.16 (95% confidence interval = 2.00-4.97, P < .001).
  
  
  CONCLUSIONS
  These data suggest that the Hardman index can predict an increased risk of 30-day mortality from endovascular repairs of ruptured aortic aneurysms. However, mortality from endovascular repair is much lower than would be predicted in open repair and it therefore cannot be used clinically as a tool for exclusion from intervention.
authors.affiliation: Queen's Medical Centre, and Department of Radiology, Manchester Royal Infirmary, Manchester, UK. d.conroy@doctors.net.uk
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Conroy
authors.forename: Nishath
authors.initials: N
authors.lastname: Altaf
authors.forename: Steve D
authors.initials: SD
authors.lastname: Goode
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Braithwaite
authors.forename: Shane T
authors.initials: ST
authors.lastname: MacSweeney
authors.forename: Toby
authors.initials: T
authors.lastname: Richards
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000097:blood / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000097:blood / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D015415:Biomarkers / Q000032:analysis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality*; D003404:Creatinine / Q000097:blood; D004562:Electrocardiography; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality*; D004739:England; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D017202:Myocardial Ischemia / Q000401:mortality; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014474:Unconsciousness / Q000401:mortality
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D003404:Creatinine