Validating three scoring systems for predicting mortality after a ruptured abdominal aortic aneurysm repair in a multi-centre New Zealand population

Jhanvi Dholakia; Anantha Narayanan; Philip Allan; Stephen French; Chris Frampton; Damian Kelleher; Manar Khashram

doi:10.1016/j.avsg.2025.09.045

Validating three scoring systems for predicting mortality after a ruptured abdominal aortic aneurysm repair in a multi-centre New Zealand population

Jhanvi Dholakia, Anantha Narayanan, Philip Allan, Stephen French, Chris Frampton, Damian Kelleher Manar Khashram

Annals of vascular surgery, Vol.123, pp.215-221

06/10/2025

: https://doi.org/10.1016/j.avsg.2025.09.045

https://hdl.handle.net/10523/48377

Objectives: Several scores exist to predict 30 day mortality after intervention for a ruptured abdominal aortic aneurysm (rAAA). This multicentre study is the first to compare the performance of three scores in an Australasian cohort, including non-operative and indigenous populations. Methods: All patients presenting with a rAAA managed operatively and non-operatively between 2010 and 2024 to five hospitals in in the Midland region of New Zealand were included. Three risk prediction scores were calculated: Harborview Risk Score (HRS), Edinburgh Ruptured Aneurysm Score (ERAS) and Glasgow Aneurysm Score (GAS). The discriminative ability of the scores was calculated using receiver operating characteristics (ROC) curves. Results: A total of 256 patients were included in this study. The HRS score was a better predictor of 30-day mortality in both operative groups, with an AUC of 0.83 (p-value 0.042 vs all) in the endovascular group and 0.69 (p-value 0.086 vs. all) in the open repair group. The ERAS and GAS scores had an AUC 0.664 and 0.612 respectively and thus performed less well at predicting 30-day mortality. There was a 2.4-fold increase in 30-day mortality with each increase in HRS point (OR 2.4, 95%CI 1.68-3.56, p-value <0.001). Conclusions: Of all the scores, the HRS demonstrated the best discriminative ability to predict 30-day mortality in open and endovascular repairs. The risk prediction scores in conjunction with clinical assessments of patients can be used to assist in the clinical decision-making process for patients presenting with a rAAA.

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https://doi.org/10.1016/j.avsg.2025.09.045

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: Validating three scoring systems for predicting mortality after a ruptured abdominal aortic aneurysm repair in a multi-centre New Zealand population
: Jhanvi Dholakia
Anantha Narayanan
Philip Allan
Stephen French
Chris Frampton
Damian Kelleher
Manar Khashram
: Annals of vascular surgery, Vol.123, pp.215-221
: Medicine (UOC)
: Elsevier
: 06/10/2025
: Copyright © The Author(s) 2025. This work was first published in Annals of Vascular Surgey (Elsevier). This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial use, distribution and reproduction in any medium, provided the original work is properly attributed to the creator(s) and the source, is not altered, transformed, or built upon in any way, and a link to the Creative Commons license is provided.
: English
: Journal article