Hardman Index (Ruptured Abdominal Aortic Aneurysm)
The Hardman index (Hardman and colleagues 1996) counts five factors present at presentation with a ruptured abdominal aortic aneurysm.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Age over 76 years?
- Yes
- Serum creatinine over 190 micromol/L (0.19 mmol/L, about 2.15 mg/dL)?
- Yes
- Hemoglobin below 9.0 g/dL (90 g/L)?
- Yes
- Loss of consciousness after presentation?
- No
- ECG evidence of ischemia
- No
Result: Hardman index 3 of 5.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- 0 to 2
- The original series observed 16, 37, and 72 percent mortality. Those bands trace to that single 1996 cohort.
- 3 or more
- The original series observed 100 percent, but in only 8 patients. A pooled analysis of about 970 found 77 percent.
- Refuted use
- An index of 3 or more cannot be used as an absolute limit for denial of surgery. High-risk patients may still survive.
- Scope
- Does not diagnose rupture, does not choose open versus endovascular repair, and does not settle goals of care.
What you enter
- Age over 76 years?
- Serum creatinine over 190 micromol/L (0.19 mmol/L, about 2.15 mg/dL)?
- Hemoglobin below 9.0 g/dL (90 g/L)?
- Loss of consciousness after presentation?
- ECG evidence of ischemia: ST depression over 1 mm and/or associated T-wave changes?
Full field descriptions
- Age over 76 years? Strictly over 76.
- Serum creatinine over 190 micromol/L (0.19 mmol/L, about 2.15 mg/dL)? One secondary source renders this as 180 micromol/L; that is a transcription error against the original.
- Hemoglobin below 9.0 g/dL (90 g/L)? Measured on presentation.
- Loss of consciousness after presentation? After arrival, not a transient episode before it.
- ECG evidence of ischemia: ST depression over 1 mm and/or associated T-wave changes? The original defines it by that ECG appearance rather than by a clinical history of ischemia.
How this is calculated
- Factors
- Age over 76, creatinine over 190 micromol/L, hemoglobin below 9.0 g/dL, loss of consciousness after presentation, ECG ischemia. One point each.
Hardman DT, Fisher CM, Patel MI, et al. Ruptured abdominal aortic aneurysms: who should be offered surgery? J Vasc Surg. 1996;23(1):123-129. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.