Validity of the Glasgow Aneurysm Score and the Hardman Index in predicting outcome after ruptured abdominal aortic aneurysm repair

Abstract

Background: The Glasgow Aneurysm Score and the Hardman Index have been recommended as predictors of outcome after repair of ruptured abdominal aortic aneurysm (AAA). This study aimed to assess their validities. Methods: Patients admitted to a single unit with a ruptured AAA over a 2‐year interval (2000–2001) were identified from a prospectively compiled database. Hospital records of all patients undergoing attempted operative repair were reviewed. The Glasgow Aneurysm Score and the Hardman Index were calculated retrospectively and related to clinical outcome. Results: One hundred patients were admitted with a ruptured AAA. Of these, 82 underwent attempted operative repair and were included in the study: 68 men and 14 women, of median age 73 (range 54–87) years. Thirty (37 per cent) patients died after the operation. The Glasgow Aneurysm Score was a poor predictor of postoperative mortality. The area under the Receiver–Operator Characteristic curve was 0·606 (P = 0·112, 95 per cent c.i. 0·483–0·729). Similarly, the Hardman Index failed to predict postoperative mortality accurately (P = 0·211, χ² for trend). Of nine patients in this series with three or more Hardman criteria, generally held to be fatal, six survived. Conclusion: Contrary to previous reports, The Glasgow Aneurysm Score and the Hardman Index were poor predictors of postoperative mortality after repair of a ruptured AAA in this study. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.