Predicting in-hospital death in patients with type B acute aortic dissection

Abstract

The outcome of patients with acute type B aortic dissection (BAAD) is largely dictated by whether or not the case is “complicated.” The purpose of this study was to investigate the risk factors leading to in-hospital death among patients with BAAD and then to develop a predictive model to estimate individual risk of in-hospital death. A total of 188 patients with BAAD were enrolled. Risk factors for in-hospital death were investigated with univariate and multivariable logistic regression analysis. Significant risk factors were used to develop a predictive model. The in-hospital mortality rate was 9% (17 of 188 patients). Univariate analysis revealed 7 risk factors to be statistically significant predictors of in-hospital death ( P < .1). In multivariable analysis, the following variables at admission were independently associated with increased in-hospital mortality: hypotension (odds ratio [OR], 4.85; 95% confidence interval [CI], 1.12–18.90; P = .04), ischemic complications (OR, 8.24; 95% CI, 1.25–33.85; P < .001), renal dysfunction (OR, 12.32; 95% CI, 10.63–76.66; P < .001), and neutrophil percentage ≥80% (OR, 5.76; 95% CI, 2.58–12.56; P = .03). Based on these multivariable results, a reliable and simple prediction model was developed, a total score of 4 offered the best point value. Independent risk factors associated with in-hospital death can be predicted in BAAD patients. The prediction model could be used to identify the prognosis for BAAD patients and assist physicians in their choice of management.

Prognostic dynamic nomogram integrated with metabolic acidosis for in-hospital mortality and organ malperfusion in acute type B aortic dissection patients undergoing thoracic endovascular aortic repair

“…According with previous studies [ 4 , 7 , 16 ], patients with a maximum aortic diameter ≥ 5.5 cm, renal dysfunction or albumin amount ≤ 30 g/L were more likely to experience in-hospital mortality or organ malperfusion. D-dimer level ≥ 5.44 μg/mL was the last identified risk factor.…”

“…The early identification of risk factors for post-operative mortality and malperfusion, and then intervening reversible risk factors are essential to improve patients’ outcomes and limiting downstream costs. Several risk factors and predictive models for early prognosis have been presented [ 4 , 7 ]. However, few studies considered metabolic acidosis, which is generally related to organ malperfusion and mortality [ 5 ].…”

Preoperative hematological parameters are inadequate for predicting mortality in Stanford Type A aortic dissection repair

“…In previous studies, the efficacy of hematological markers, a simple and inexpensive method, predicting thrombosis, inflammation, and mortality was investigated. Most of the studies conducted to show mortality are related to Type B AAD [10] . The time from diagnosis to surgery may allow such assessments in patients diagnosed with Type B AAD.…”

Serum amyloid a protein as a potential biomarker in predicting acute onset and association with in-hospital death in acute aortic dissection

“…Our results suggest that SAA levels in AAA patients may be a critical marker of all-cause mortality in AAD. Additionally, it has been reported previously that CRP, D-Dimer [12] and NE% [35] are important risk factors for in-hospital mortality in AAD. In our study, we observed that CRP with AUC of 0.826, the highest sensitivity and specificity, is the best prognostic indicator of the mortality, and the AUC of SAA in predicting in-hospital mortality (AUC = 0.732) is better than that of D-Dimer (AUC = 0.715) and NE% (AUC = 0.678).…”