Prediction of mortality rate in acute type A dissection: the German Registry for Acute Type A Aortic Dissection score

Czerny, Martin; Siepe, Matthias; Beyersdorf, Friedhelm; Feisst, Manuel; Gabel, Michael; Pilz, Maximilian; Poeling, Jochen; Dohle, Daniel-Sebastian; Sarvanakis, Konstantinos; Luehr, Maximilian; Hagl, Christian; Rawa, Arif; Schneider, Wilke; Detter, Christian; Holubec, Tomas; Borger, Michael; Boening, Andreas und Rylski, Bartosz (2020): Prediction of mortality rate in acute type A dissection: the German Registry for Acute Type A Aortic Dissection score. In: European Journal of Cardio-Thoracic Surgery, Bd. 58, Nr. 4: S. 700-706

Abstract

OBJECTIVES: The goal was to develop a scoring system to predict the 30-day mortality rate for patients undergoing surgery for acute type A aortic dissection on the basis of the German Registry for Acute Type A Aortic Dissection (GERAADA) data set and to provide a Webbased application for standard use. METHODS: A total of 2537 patients enrolled in GERAADA who underwent surgery between 2006 and 2015 were analysed. Variable selection was performed using the R-package FAMoS. The robustness of the results was confirmed via the bootstrap procedure. The coefficients of the final model were used to calculate the risk score in a Web-based application. RESULTS: Age [odds ratio (OR) 1.018, 95% confidence interval (CI) 1.009-1.026;P < 0.001;5-year OR: 1.093], need for catecholamines at referral (OR 1.732, 95% CI 1.340-2.232;P < 0.001), preoperative resuscitation (OR 3.051, 95% CI 2.099-4.441;P < 0.001), need for intubation before surgery (OR 1.949, 95% CI 1.465-2.585;P < 0.001), preoperative hemiparesis (OR 1.442, 95% CI 0.996-2.065;P = 0.049), coronary malperfusion (OR 1.870, 95% CI 1.386-2.509;P < 0.001), visceral malperfusion (OR 1.748, 95% CI 1.198-2.530;P = 0.003), dissection extension to the descending aorta (OR 1.443, 95% CI 1.120-1.864;P = 0.005) and previous cardiac surgery (OR 1.772, 95% CI 1.048-2.903;P = 0.027) were independent predictors of the 30-day mortality rate. The Web application based on the final model can be found at https://www.dgthg.de/de/GERAADA_Score. CONCLUSIONS: The GERAADA score is a simple, effective tool to predict the 30-day mortality rate for patients undergoing surgery for acute type A aortic dissection. We recommend the widespread use of this Web-based application for standard use.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1010-7940
• Sprache: Englisch