Assessing GERAADA Score Mortality Predictions in Type A Aortic Dissection Patients

Abstract

Objective: This study seeks to assess the predictive precision of the GERAADA score for 30-day mortality in patients with Type A aortic dissection. Methods: A retrospective study analyzed data from 382 survivors and 90 non-survivors, examining demographic, clinical, and surgical variables. GERAADA scores were calculated by a blinded cardiac surgeon using a web-based application. Results: The overall mortality is 19.06% and 18.18% for GERAADA prediction. The presence of malperfusion in more than two organs emerged as a significant risk factor for hospital mortality p=0.028. Longer surgery times were significantly associated with elevated mortality p=0.002. Moreover, postoperative ECMO, CPR, and IABP were significantly linked to increased mortality rates. Additionally, ICU stay duration, lung infection, MODS, and respiratory failure p<0.05 independently posed as risk factors for hospital mortality. Patients with Hemiparesis and peripheral malperfusion experienced no deaths, as predicted by GERAADA score. Additionally, patients with a dissection tear located at the root of the aorta exhibited a lower mortality rate of 7.14%, contrasting the higher 19.87% GERAADA prediction. Conclusion: GERAADA predictions were mostly accurate, but exceptions occurred with inotrope use, hemiparesis, peripheral malperfusion, and aortic dissection at the root. We suggest enhancing the GERAADA score by incorporating intraoperative and postoperative factors.