Evaluation of Two Online Risk Prediction Models for the Mortality Rate of Acute Type A Aortic Dissection Surgery: The German Registry of Acute Aortic Dissection Type A Score and the European System for Cardiac Operative Risk Evaluation II
Abstract
:1. Introduction
2. Materials and Methods
2.1. Ethics Statement
2.2. Population and Settings
2.3. Data Collection
2.4. Definitions
2.5. Arch Surgical Approach
2.6. Deep Hypothermia Cardiac Arrest Method
2.7. Statistical Analysis
3. Results
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Number of Patients (%) |
---|---|
Age (year), media (IQR) | 53 (44, 63) |
Sex (female) | 326 (24.2) |
Resuscitation before surgery | 38 (2.8) |
Previous cardiac surgery | 14 (1.0) |
Intubation/ventilation at referral | 38 (2.8) |
Catecholamines at referral | 38 (2.8) |
Aortic valve regurgitation | |
| 978 (72.7) |
| 162 (12.0) |
| 206 (15.3) |
Preoperative organ malperfusion | |
| 1015 (75.4) |
| 13 (1.0) |
| 17 (1.3) |
| 309 (23.0) |
Preoperative hemiparesis | 7 (0.5) |
Extension of disscection | |
| 1346 (100.0) |
| 205 (15.2) |
| 1346 (100.0) |
Location of primary entry tear within aortic arch | 418 (31.1) |
Characteristics | Number of Patients (%) | Characteristics | Number of Patients (%) |
---|---|---|---|
Age (year), media (IQR) | 53 (44, 63) | Weight of the operation | |
Sex (female) | 326 (24.2) |
| 0 (0) |
Chronic pulmonary disease | 54 (4.0) |
| 653 (48.5) |
Extracardiac arteriopathy | 309 (23.0) |
| 362 (26.9) |
Poor mobility | 7 (0.5) | Graft interposition + CABG | 36 (2.7) |
Previous cardiac surgery | 14 (1.0) | Graft interposition + AVr/AVR | 48 (3.6) |
Active endocarditis | 0 (0) | Graft interposition + MVr/MVR | 2 (0.1) |
Critical preoperative state | 38 (2.8) | Graft interposition + TVr | 5 (0.4) |
Renal impairment (ml/min) | Total arch replacement | 271 (20.1) | |
| 766 (56.9) |
| 331 (24.6) |
| 383 (28.5) | Graft interposition + AVR + CABG/AVr + MVr/CABG + TVr/MVR + TVr | 7 (0.5) |
| 184 (13.7) | Bentall | 160 (11.9) |
| 13 (1.0) | Bentall + CABG/MVr/MVR/TVr | 32 (2.4) |
Diabetes on insulin | 61 (4.5) | David | 12 (0.9) |
CCS angina class 4 | 13 (1.0) | David + CABG/MVr/MVR/TVr | 2 (0.1) |
Recent MI | 13 (1.0) | Total arch replacement + Bentall | 64 (4.8) |
Surgery on thoracic aorta | 1346 (100) | Total arch replacement + Bentall + CABG/MVr + TVr/TVr | 6 (0.4) |
Urgency | Total arch replacement + David | 2 (0.1) | |
| 517 (38.4) | Total arch replacement + CABG | 18 (1.3) |
| 829 (61.6) | Total arch + AVr/MVr/MVR/TVr | 21 (1.6) |
Threshold | Specificity, % | Sensitivity, % | Accuracy, % | PLR | NLR | PPV, % | NPV, % | |
---|---|---|---|---|---|---|---|---|
Patients (n = 1346) | ||||||||
GERAADA score | 14.5 | 51.2 | 66.7 | 53.1 | 1.37 | 0.65 | 16.3 | 91.5 |
EuroSCORE II | 4.25 | 73.9 | 51.2 | 71.1 | 1.96 | 0.66 | 21.9 | 91.4 |
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Ma, M.; Cao, H.; Li, K.; Pan, J.; Zhou, Q.; Tang, X.; Qin, X.; Zhu, F.; Wang, D. Evaluation of Two Online Risk Prediction Models for the Mortality Rate of Acute Type A Aortic Dissection Surgery: The German Registry of Acute Aortic Dissection Type A Score and the European System for Cardiac Operative Risk Evaluation II. J. Clin. Med. 2023, 12, 4728. https://doi.org/10.3390/jcm12144728
Ma M, Cao H, Li K, Pan J, Zhou Q, Tang X, Qin X, Zhu F, Wang D. Evaluation of Two Online Risk Prediction Models for the Mortality Rate of Acute Type A Aortic Dissection Surgery: The German Registry of Acute Aortic Dissection Type A Score and the European System for Cardiac Operative Risk Evaluation II. Journal of Clinical Medicine. 2023; 12(14):4728. https://doi.org/10.3390/jcm12144728
Chicago/Turabian StyleMa, Ming, Hailong Cao, Kai Li, Jun Pan, Qing Zhou, Xinlong Tang, Xichun Qin, Feng Zhu, and Dongjin Wang. 2023. "Evaluation of Two Online Risk Prediction Models for the Mortality Rate of Acute Type A Aortic Dissection Surgery: The German Registry of Acute Aortic Dissection Type A Score and the European System for Cardiac Operative Risk Evaluation II" Journal of Clinical Medicine 12, no. 14: 4728. https://doi.org/10.3390/jcm12144728