Department of Radiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Department of Radiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Eur J Radiol. 2024 Jun;175:111469. doi: 10.1016/j.ejrad.2024.111469. Epub 2024 Apr 16.
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.
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.
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).
Adding ascending aorta length and pericardial effusion to the GERAADA Score can improve the predictive power of 30-day mortality in patients with ATAAD.
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。本研究旨在构建预测 ATAAD 患者 30 天死亡风险的模型，并验证德国 A 型急性主动脉夹层登记处（GERAADA）评分和欧洲心脏手术风险评估系统（EuroSCORE II）的预测准确性。
2019 年 6 月至 2023 年 6 月，我院收治 109 例 ATAAD 患者（死亡组 35 例，存活组 74 例），比较两组患者的影像学参数差异，寻找独立预测因子，建立预测 ATAAD 患者 30 天死亡率的模型。回顾性计算 GERAADA 评分和 EuroSCORE II，并使用受试者工作特征（ROC）曲线评估其指示死亡率。
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子。我们构建了四个模型，分别为 GERAADA 评分（模型 1）、EuroSCORE II（模型 2）、模型 1、升主动脉长度和心包积液（模型 3）以及模型 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）的 AUC 差异有统计学意义（p<0.05，DeLong 检验）。
在 GERAADA 评分中加入升主动脉长度和心包积液可以提高预测 ATAAD 患者 30 天死亡率的预测能力。
