PMID- 18639420
OWN - NLM
STAT- MEDLINE
DCOM- 20081204
LR  - 20121003
IS  - 1097-6809 (Electronic)
IS  - 0741-5214 (Linking)
VI  - 48
IP  - 4
DP  - 2008 Oct
TI  - Usefulness of the Hardman index in predicting outcome after endovascular repair 
      of ruptured abdominal aortic aneurysms.
PG  - 788-94
LID - 10.1016/j.jvs.2008.05.065 [doi]
AB  - OBJECTIVES: The Hardman index, which has five variables, has been recommended as 
      a predictor of outcome after open repair of ruptured abdominal aortic aneurysms 
      (RAAAs). It has been reported that the presence of three or more variables is 
      uniformly fatal. The aim of this study was to test the same model in an 
      independent series of RAAA patients undergoing endovascular repair. METHODS: A 
      consecutive series of 41 patients undergoing endovascular repair for RAAA during 
      an 8-year period was analyzed retrospectively. Thirty-day mortality and patient 
      variables, including the five Hardman risk factors of age >76 years, serum 
      creatinine >190 micromol/L, hemoglobin <9 g/dL, loss of consciousness, and 
      electrocardiographic (ECG) evidence of ischemia, were recorded. The Hardman index 
      and a revised version of the index with four variables (without ECG ischemia) 
      were calculated and related to clinical outcome. RESULTS: Operative mortality was 
      41% (17 of 41). On univariate analysis, only age >76 years (P = .01) and the use 
      of local anesthesia (P < .0001) were statistically significant. Loss of 
      consciousness (P = .05) showed a trend toward a higher mortality, albeit not 
      statistically significant. On multivariate analysis, the use of local anesthesia 
      was the only significant predictor of survival (odds ratio [OR], 0.03; 95% 
      confidence interval [CI], 0.003-0.25, P = .001). Again, loss of consciousness 
      showed an association with a higher chance of dying but did not achieve 
      statistical significance (OR, 6.30; 95% CI, 0.93-42.51, P = .059). The original 
      and revised versions of the Hardman index were both significantly associated with 
      death (P = .02 and P = .001, chi(2) test for trend). The cumulative effect of 0, 
      1, 2, and >/=3 risk factors on mortality was 0%, 27%, 36%, and 71% for the 
      original index, and 12.5%, 21%, 60%, and 78% for the revised version, 
      respectively. Four and two patients with a score of >/=3 in each version of the 
      index survived endovascular repair. CONCLUSIONS: The Hardman index, with or 
      without incorporating ECG ischemia, seems to be a simple and useful predictive 
      tool in patients undergoing endovascular repair of RAAA, with the mortality rate 
      increasing along with the Hardman score. However, the index cannot be used to 
      accurately identify patients with no chance of survival after endovascular 
      repair.
FAU - Karkos, Christos D
AU  - Karkos CD
AD  - Fifth Department of Surgery, Aristotle University of Thessaloniki, Hippocrateio 
      Hospital, Thessaloniki, Greece.
FAU - Karamanos, Dimitrios
AU  - Karamanos D
FAU - Papazoglou, Konstantinos O
AU  - Papazoglou KO
FAU - Kantas, Alexandros S
AU  - Kantas AS
FAU - Theochari, Evangelia G
AU  - Theochari EG
FAU - Kamparoudis, Apostolos G
AU  - Kamparoudis AG
FAU - Gerassimidis, Thomas S
AU  - Gerassimidis TS
LA  - eng
PT  - Journal Article
DEP - 20080717
PL  - United States
TA  - J Vasc Surg
JT  - Journal of vascular surgery
JID - 8407742
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Angioplasty
MH  - Aortic Aneurysm, Abdominal/*surgery
MH  - *Aortic Rupture
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Risk Assessment
MH  - Stents
EDAT- 2008/07/22 09:00
MHDA- 2008/12/17 09:00
CRDT- 2008/07/22 09:00
PHST- 2007/06/05 00:00 [received]
PHST- 2008/05/19 00:00 [revised]
PHST- 2008/05/19 00:00 [accepted]
PHST- 2008/07/22 09:00 [pubmed]
PHST- 2008/12/17 09:00 [medline]
PHST- 2008/07/22 09:00 [entrez]
AID - S0741-5214(08)00868-9 [pii]
AID - 10.1016/j.jvs.2008.05.065 [doi]
PST - ppublish
SO  - J Vasc Surg. 2008 Oct;48(4):788-94. doi: 10.1016/j.jvs.2008.05.065. Epub 2008 Jul 
      17.