Abstract：
OBJECTIVE: Acute type A aortic dissection (ATAAD) is a life-threatening cardiovascular disease that requires an effective predictive model to predict and assess a patient\'s risk of death. Our study aimed to construct a model for predicting the risk of 30-day death in patients with ATAAD and the prediction accuracy of the German Registry of Acute Aortic Dissection Type A (GERAADA) Score and the European System for Cardiac Operative Risk Evaluation (EuroSCORE II) was verified.
METHODS: Between June 2019 and June 2023, 109 patients with ATAAD underwent surgical treatment at our hospital (35 in the death group and 74 in the survival group). The differences in image parameters between the two groups were compared. Search for independent predictors and develop models that predict 30-day mortality in patients with ATAAD. GERAADA Score and EuroSCORE II were retrospectively calculated and indicated mortality was assessed using the receiver operating characteristic (ROC) curve.
RESULTS: Logistic regression analysis showed that ascending aortic length and pericardial effusion were independent predictors of death within 30 days in patients with ATAAD. We constructed four models, GERAADA Score (Model 1), EuroSCORE II (Model 2), Model 1, ascending aorta length, and pericardial effusion (Model 3), and Model 2, ascending aorta length, and pericardial effusion (Model 4). The area under the curve (AUC = 0.832) of Model 3 was significantly different from those of Models 1 (AUC = 0.683) and 2 (AUC = 0.599), respectively (p < 0.05, DeLong test).
CONCLUSIONS: Adding ascending aorta length and pericardial effusion to the GERAADA Score can improve the predictive power of 30-day mortality in patients with ATAAD.
METHODS: Between June 2019 and June 2023, 109 patients with ATAAD underwent surgical treatment at our hospital (35 in the death group and 74 in the survival group). The differences in image parameters between the two groups were compared. Search for independent predictors and develop models that predict 30-day mortality in patients with ATAAD. GERAADA Score and EuroSCORE II were retrospectively calculated and indicated mortality was assessed using the receiver operating characteristic (ROC) curve.
RESULTS: Logistic regression analysis showed that ascending aortic length and pericardial effusion were independent predictors of death within 30 days in patients with ATAAD. We constructed four models, GERAADA Score (Model 1), EuroSCORE II (Model 2), Model 1, ascending aorta length, and pericardial effusion (Model 3), and Model 2, ascending aorta length, and pericardial effusion (Model 4). The area under the curve (AUC = 0.832) of Model 3 was significantly different from those of Models 1 (AUC = 0.683) and 2 (AUC = 0.599), respectively (p < 0.05, DeLong test).
CONCLUSIONS: Adding ascending aorta length and pericardial effusion to the GERAADA Score can improve the predictive power of 30-day mortality in patients with ATAAD.
摘要：
目的：急性A型主动脉夹层（ATAAD）是一种危及生命的心血管疾病，需要有效的预测模型来预测和评估患者的死亡风险。我们的研究旨在构建一个模型来预测ATAAD患者30天死亡的风险，并验证了德国急性主动脉夹层A型注册中心（GERAADA）评分和欧洲心脏手术风险评估系统（EuroSCOREII）的预测准确性。
方法：在2019年6月至2023年6月期间，109例ATAAD患者在我院接受了手术治疗（死亡组35例，存活组74例）。比较两组图像参数的差异。寻找独立的预测因子，并建立预测ATAAD患者30天死亡率的模型。回顾性计算GERAADA评分和EuroSCOREII，并使用受试者工作特征（ROC）曲线评估死亡率。
结果：Logistic回归分析显示，升主动脉长度和心包积液是ATAAD患者30天内死亡的独立预测因素。我们构建了四个模型，GERAADA评分（模型1），EuroSCOREII（模型2），模型1，升主动脉长度，和心包积液（模型3），和模型2，升主动脉长度，和心包积液（模型4）。模型3的曲线下面积(AUC=0.832)与模型1(AUC=0.683)和模型2(AUC=0.599)显著不同,分别为(p<0.05，DeLong检验)。
结论：在GERAADA评分中加入升主动脉长度和心包积液可以提高ATAAD患者30天死亡率的预测能力。
方法：在2019年6月至2023年6月期间，109例ATAAD患者在我院接受了手术治疗（死亡组35例，存活组74例）。比较两组图像参数的差异。寻找独立的预测因子，并建立预测ATAAD患者30天死亡率的模型。回顾性计算GERAADA评分和EuroSCOREII，并使用受试者工作特征（ROC）曲线评估死亡率。
结果：Logistic回归分析显示，升主动脉长度和心包积液是ATAAD患者30天内死亡的独立预测因素。我们构建了四个模型，GERAADA评分（模型1），EuroSCOREII（模型2），模型1，升主动脉长度，和心包积液（模型3），和模型2，升主动脉长度，和心包积液（模型4）。模型3的曲线下面积(AUC=0.832)与模型1(AUC=0.683)和模型2(AUC=0.599)显著不同,分别为(p<0.05，DeLong检验)。
结论：在GERAADA评分中加入升主动脉长度和心包积液可以提高ATAAD患者30天死亡率的预测能力。
