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Utility of Established Risk Models to Predict Surgical Mortality in Acute Type-A Aortic Dissection.

Abstract：

OBJECTIVE:The objective of this study was to determine the predictive value of 2 established risk models for surgical mortality in a contemporary cohort of patients undergoing repair of acute type-A aortic dissection. DESIGN:Retrospective analysis. SETTING:Single tertiary care hospital. PARTICIPANTS:Seventy-nine consecutive patients undergoing emergent repair of acute type-A aortic dissection between 2008 and 2013. INTERVENTION:All patients underwent emergent repair of acute type-A aortic dissection. MEASUREMENTS AND MAIN RESULTS:The receiver operating characteristic curve was compared for each scoring system. Of the 79 patients undergoing emergent repair of acute type-A aortic dissection, 23 (29.1%) were above the age of 70. Seventeen (21.5%) patients presented with hypotension, 25 (31.6%) presented with limb ischemia, and 10 (12.7%) presented with evidence of visceral ischemia. Overall operative mortality was 16.5%. Increasing age was the only preoperative variable associated with increased operative mortality. The areas under the receiver operating characteristic curve for operative mortality was 0.62 and 0.66 for the scoring systems developed by Rampoldi et al and Centofanti et al, respectively. The area under the receiver operating characteristic curve for operative mortality for age was 0.67. The areas under the receiver operating characteristic curve for operative mortality between the 2 scoring systems and for age were not statistically different. CONCLUSIONS:Existing predictive risk models for acute type-A aortic dissection provide moderate discriminatory power for operative mortality. Age as a single variable may provide equivalent discriminatory power for operative mortality as the established risk models.

journal_name

J Cardiothorac Vasc Anesth

journal_title

Journal of cardiothoracic and vascular anesthesia

authors

Yu PJ,Cassiere HA,Kohn N,Dellis SL,Manetta F,Esposito RA,Hartman AR

doi

10.1053/j.jvca.2015.08.008

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

39-43

issue

eissn

1053-0770

issn

1532-8422

pii

S1053-0770(15)00784-3

journal_volume

pub_type

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Utility of Established Risk Models to Predict Surgical Mortality in Acute Type-A Aortic Dissection.