School of Medicine, Southeast University, Nanjing, Jiangsu, 210009, China.
The Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Changle Road 68, Nanjing, Jiangsu, 210006, People's Republic of China.
J Cardiothorac Surg. 2024 Jun 24;19(1):362. doi: 10.1186/s13019-024-02921-6.
Acute type A aortic dissection is a dangerous disease that threatens public health. In recent years, with the progress of medical technology, the mortality rate of patients after surgery has been gradually reduced, leading that previous prediction models may not be suitable for nowadays. Therefore, the present study aims to find new independent risk factors for predicting in-hospital mortality and construct a nomogram prediction model.
The clinical data of 341 consecutive patients in our center from 2019 to 2023 were collected, and they were divided into two groups according to the death during hospitalization. The independent risk factors were analyzed by univariate and multivariate logistic regression, and the nomogram was constructed and verified based on these factors.
age, preoperative lower limb ischemia, preoperative activated partial thromboplastin time (APTT), preoperative platelet count, Cardiopulmonary bypass (CPB) time and postoperative acute kidney injury (AKI) independently predicted in-hospital mortality of patients with acute type A aortic dissection after surgery. The area under the receiver operating characteristic curve (AUC) for the nomogram was 0.844. The calibration curve and decision curve analysis verified that the model had good quality.
The new nomogram model has a good ability to predict the in-hospital mortality of patients with acute type A aortic dissection after surgery.
急性 A 型主动脉夹层是一种危害公众健康的危险疾病。近年来,随着医疗技术的进步,患者手术后的死亡率逐渐降低,这使得以前的预测模型可能不再适用于当今。因此,本研究旨在寻找新的独立风险因素来预测住院期间的死亡率,并构建列线图预测模型。
收集了 2019 年至 2023 年期间我中心连续 341 例患者的临床资料,根据住院期间的死亡情况将其分为两组。通过单因素和多因素逻辑回归分析独立风险因素,并基于这些因素构建和验证列线图。
年龄、术前下肢缺血、术前活化部分凝血活酶时间(APTT)、术前血小板计数、体外循环(CPB)时间和术后急性肾损伤(AKI)独立预测了急性 A 型主动脉夹层患者手术后的住院死亡率。列线图的受试者工作特征曲线下面积(AUC)为 0.844。校准曲线和决策曲线分析验证了该模型具有良好的质量。
新的列线图模型具有良好的预测急性 A 型主动脉夹层患者手术后住院死亡率的能力。