Prediction of 30-Day Mortality by the Harborview Risk Score in Ruptured Abdominal Aortic Aneurysm: Systematic Review and Meta-Analysis

Abstract

Introduction: Ruptured abdominal aortic aneurysm (RAAA) is a very severe condition with 17.4%–45.1% 30-day mortality rates. The 30-day death prediction model for patients with RAAA is one of the most significant models developed by Harborview Medical Center (HMC). The Harborview Risk Score (HRS) was calculated using the following four preoperative factors: minimum systolic blood pressure, age, Pondus Hydrogenii (pH), and creatinine (Cr). The objective was to evaluate the validity and dependability of the HMC model for predicting 30-day mortality with a large data sample.

Methods: The medical subject heading (MeSH) was used to search the electronic database. Four key indicators, the 30-day mortality rate, and the HRS score were among the data that were retrieved. The inclusion criteria include RAAA patients, applying the HMC prediction model and with baseline data, and the exclusion criteria include other prediction models and studies with incomplete baseline data from patients.

Results: There were 2931 participants in total throughout 7 trials; 1536 of these patients came from the National Surgical Quality Improvement Program (NSQIP) database, and the other patients came from single center in each project. Thirty-day mortality was 34.9% (95% CI: 0.27–0.33) on average. The majority of the patients (n = 2616, 89.25%) had an HRS score of 0–2. All patients who had a score of 4 died, no matter which single center they were in. Furthermore, with every extra point that a patient with a score of 0–3 received, their death rate rose by around 15%–20%.

Conclusion: The HMC prediction model is a trustworthy prediction model that can more simply and accurately predict 30-day postoperative mortality through the use of age, pH, Cr, and minimum systolic blood pressure. It also provides more preoperative counsel and assessment to the patient, family, and physician.