Review of Scoring Systems for Predicting 30-Day Mortality in Ruptured Abdominal Aortic Aneurysm

Background

Ruptured abdominal aortic aneurysms (rAAAs) are a serious disease that can lead to high mortality; thus, their early prediction can save patients' lives. The aim of this study was to compare the accuracies of various models for predicting rAAA mortality—including the Glasgow Aneurysm Score, Vancouver Scoring System, Dutch Aneurysm Score, Edinburgh Ruptured Aneurysm Score (ERAS), and Hardman index—based on rAAA treatment outcomes at our institution.

Methods

Between 2016 and 2022, we retrospectively analyzed the early outcome data—including 30-day mortality—of patients who underwent emergency surgery for rAAA at our institution. Receiver operating characteristic curve analysis was performed to compare the aneurysm scoring systems for mortality using the area under the receiver operating characteristic curve (AUC).

Results

The AUC was better for the ERAS (0.718; 95% confidence interval, 0.601–0.817) than for the other scoring systems. Significant differences were observed between ERAS and Hardman indices (difference: 0.179; P = 0.016). No significant differences were found among the Glasgow Aneurysm Score, Vancouver Scoring System, and Dutch Aneurysm Score predictive risk models.

Conclusions

Among the models for predicting mortality in patients with rAAA, the ERAS model demonstrated the highest AUC value; however, significant differences were only observed between ERAS and Hardman indices. This study may help develop strategies for improving rAAA prediction.