A preoperative mortality risk assessment model for Standford type A acute aortic dissection

Abstract

OBJECTIVES Acute aortic dissection type A is a life-threatening disease required emergency surgery during acute phase. Different clinical manifestations: laboratory tests: and imaging features of patients with acute aortic dissection type A are the risk factors of preoperative mortality. This study aims to establish a simple and effective preoperative mortality risk assessment model for patients with acute aortic dissection type A. METHODS A total of 508 Chinese patients with acute aortic dissection type A who were admitted to our hospital were retrospectively included. All patients were unable to receive surgically treatment within 3 days from the onset of disease. Multivariable analysis was used to investigate predictors of preoperative mortality and to develop a prediction model. RESULTS Among the 508 patients: 394 patients survived (77.56%) and 114 patients died (22.44%). The following independent variables increased preoperative mortality: initial pain site: chest (OR = 7.536: P = 0.021): D-Dimmer ≥ 12000 ng/ml (OR = 2.982: P < 0.001): the average ascending diameter measured by transthoracic echocardiography ≥ 55 mm (OR = 4.226: P < 0.001): moderate or massive pericardial effusion (OR = 2.534: P = 0.040): electrocardiographic myocardial ischemia (OR = 3.355: P < 0.001): patent false lumen (OR = 2.808: P < 0.001): right common carotid artery involvement (OR = 4.415: P < 0.001): false lumen /true lumen of abdominal aorta ≥ 0.75 (OR = 2.310: P = 0.011). Our data suggest that a simple and effective preoperative death risk assessment model has been established. CONCLUSIONS Using a simple and effective risk assessment model can help clinicians quickly identify high-risk patients and make appropriate medical decisions.