Prediction of mortality rate in acute type A dissection

• Verfasst von: Czerny, Martin [VerfasserIn]
• Verfasst von: Siepe, Matthias [VerfasserIn]
• Verfasst von: Beyersdorf, Friedhelm [VerfasserIn]
• Verfasst von: Feißt, Manuel [VerfasserIn]
• Verfasst von: Gabel, Michael [VerfasserIn]
• Verfasst von: Pilz, Maximilian [VerfasserIn]
• Verfasst von: Pöling, Jochen [VerfasserIn]
• Verfasst von: Dohle, Daniel-Sebastian [VerfasserIn]
• Verfasst von: Sarvanakis, Konstantinos [VerfasserIn]
• Verfasst von: Luehr, Maximilian [VerfasserIn]
• Verfasst von: Hagl, Christian [VerfasserIn]
• Verfasst von: Arif, Rawa [VerfasserIn]
• Verfasst von: Schneider, Wilke [VerfasserIn]
• Verfasst von: Detter, Christian [VerfasserIn]
• Verfasst von: Holubec, Tomas [VerfasserIn]
• Verfasst von: Borger, Michael [VerfasserIn]
• Verfasst von: Böning, Andreas [VerfasserIn]
• Verfasst von: Rylski, Bartosz [VerfasserIn]
• Titel: Prediction of mortality rate in acute type A dissection
• Titelzusatz: the German registry for acute type A aortic dissection score
• Verf.angabe: Martin Czerny, Matthias Siepe, Friedhelm Beyersdorf, Manuel Feisst, Michael Gabel, Maximilian Pilz, Jochen Pöling, Daniel-Sebastian Dohle, Konstantinos Sarvanakis, Maximilian Luehr, Christian Hagl, Arif Rawa, Wilke Schneider, Christian Detter, Tomas Holubec, Michael Borger, Andreas Böning and Bartosz Rylski
• E-Jahr: 2020
• Jahr: 3 June 2020
• Umfang: 7 S.
• Fussnoten: Gesehen am 07.12.2020
• Titel Quelle: Enthalten in: European journal of cardio-thoracic surgery
• Ort Quelle: Oxford : Oxford Univ. Press, 1987
• Jahr Quelle: 2020
• Band/Heft Quelle: 58(2020), 4, Seite 700-706
• ISSN Quelle: 1873-734X
• DOI: doi:10.1093/ejcts/ezaa156
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1742182534

Abstract

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 Web-based application for standard use.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.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.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.