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Prediction of mortality rate in acute type A dissection: the German registry for acute type A aortic dissection score

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 o...

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Main Authors: Czerny, Martin (Author) , Siepe, Matthias (Author) , Beyersdorf, Friedhelm (Author) , Feißt, Manuel (Author) , Gabel, Michael (Author) , Pilz, Maximilian (Author) , Pöling, Jochen (Author) , Dohle, Daniel-Sebastian (Author) , Sarvanakis, Konstantinos (Author) , Luehr, Maximilian (Author) , Hagl, Christian (Author) , Arif, Rawa (Author) , Schneider, Wilke (Author) , Detter, Christian (Author) , Holubec, Tomas (Author) , Borger, Michael (Author) , Böning, Andreas (Author) , Rylski, Bartosz (Author)
Format: Article (Journal)
Language:English
Published: 3 June 2020
In: European journal of cardio-thoracic surgery
Year: 2020, Volume: 58, Issue: 4, Pages: 700-706
ISSN:1873-734X
DOI:10.1093/ejcts/ezaa156
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1093/ejcts/ezaa156
Verlag, kostenfrei, Volltext: https://academic.oup.com/ejcts/article/58/4/700/5850897
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Author Notes: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
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Summary: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.
Item Description:Gesehen am 07.12.2020
Physical Description:Online Resource
ISSN:1873-734X
DOI:10.1093/ejcts/ezaa156

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