Comparison of POSSUM scoring and the Hardman Index in selection of patients for repair of ruptured abdominal aortic aneurysm

Abstract

Both POSSUM and Hardman scoring systems predicted outcome after emergency surgery for RAAA. The Hardman Index was simpler to calculate, but POSSUM identified a higher number of patients at risk. Risk scoring may help identify patients with RAAA for whom surgery is futile.

Usefulness of the Hardman index in predicting outcome after endovascular repair of ruptured abdominal aortic aneurysms

“…2,6,[8][9][10][11][12][13]16,17 These figures confirm the significant predictive effect of the index but also its failure to consistently identify a subgroup of patients with 100% mortality in which surgery should be withheld. The authors of the meta-analysis speculated that the utility of the index seemed to be impeded by variability in scoring resulting from missing or nondiagnostic data, particularly with regards to ECG.…”

“…2,[8][9][10] Subsequent studies, however, yielded inconsistent results. 6,[11][12][13][14][15][16][17] Some found the index to be a poor predictor and failed to show a statistical association with death, 12-14 whereas others found a strong correlation.…”

A randomized controlled trial of endovascular aneurysm repair versus open surgery for abdominal aortic aneurysms in low- to moderate-risk patients

“…Although it may be less accurate than scoring systems such as the Physiological and Operative Severity Score for enUmeration of Mortality and Morbidity (POSSUM) score, 16 Glasgow Aneurysm Score, 17 or the fitness score proposed by the EVAR-1 trial- ists, 18 it may have excluded severe risk factors such as renal, cardiac, or pulmonary insufficiencies more efficiently than previous trials. As in the OVER trial, and by hazard of enrollment, fewer women were enrolled which may affect the generalization of the results.…”

Do Scoring Systems Help in Predicting Survival Following Ruptured Abdominal Aortic Aneurysm Surgery?

“…8,9 With the continued emphasis on efficiency of service provision and cost-containment, the possibility of withholding repair from some patients if their death was predictable has been entertained by some authors. [10][11][12][13][14][15][16][17] A number of scoring systems have been developed with the aim of identifying patients less likely to survive surgery based on a number of pre-operative factors.…”