Pre-operative predictors of mortality in ruptured abdominal aortic aneurysms: is the Harborview Medical Center mortality risk score enough?

ABSTRACT

BACKGROUND: We aimed to evaluate the reliability of the Harborview Medical Center (HMC) mortality risk scoring system in predicting post-operative in-hospital mortality after open repair (OR) of a ruptured abdominal aortic aneurysm (rAAA) and to inves-tigate the presence of other possible mortality risk factors. METHODS: Patients who underwent OR for rAAA between January 01, 2004, and December 31, 2021, were retrospectively included in this single-center cohort study. The 30-day hospital mortality risk was calculated using the HMC risk scoring system. We as-sessed the relationship between mortality and other perioperative variables. Logistic regression analysis was performed to determine the factors affecting mortality. Receiver operating characteristic curve analysis was utilized to obtain the predictive value of the HMC mortality risk score. RESULTS: A total of 91 patients were included in this study. A statistically significant difference existed between the patients who survived and those who died. Univariate logistic regression analysis of the pre-operative patient data revealed that the hematocrit, lactate, shock index values, admission type, loss of consciousness, and HMC risk score significantly affected post-operative mortal-ity. However, in the multivariate logistic regression analysis, only the HMC risk score was associated with post-operative mortality (P<0.001). The HMC risk score could predict 30-day mortality, with an AUC of 0.912 for all patients. CONCLUSION: Our study showed that the HMC risk score could reliably predict in-hospital mortality, but it did not reveal any other parameters that further increased the reliability of this scoring system without compromising on its straightforward and practical calculation.