Salihi Salih, Özalp Bilhan, Yazıcı Yunus Emre, Kalender Mehmet, Saçlı Hakan, Kara İbrahim
Department of Cardiovascular Surgery, Medicine Faculty of Sakarya University, Sakarya, Türkiye.
Department of Cardiovascular Surgery, Kocaeli City Hospital, Kocaeli, Türkiye.
Turk Gogus Kalp Damar Cerrahisi Derg. 2024 Dec 31;32(4 Suppl 2):032-33. doi: 10.5606/tgkdc.dergisi.2024.msb-14. eCollection 2024 Nov.
This study aimed to evaluate how the German Registry of Acute Aortic Dissection Type A (GERAADA) score performs in predicting operative mortality for ATAAD.
This retrospective study included 86 consecutive patients (60 males, 26 females; mean age: 61.37±12.96 years) who underwent surgical repair for ATAAD between January 2013 and December 2023. Data collection comprised the 11 preoperative main parameters required for calculation of the new GERAADA score: age, sex, previous cardiac surgery, inotropic support at referral, resuscitation before surgery, aortic regurgitation, hemiparesis, intubation/ ventilation at referral, preoperative organ malperfusion, extension of aortic dissection, and location of primary entry site.
Two (2.3%) patients had a history of previous cardiac surgery. The GERAADA scores and postoperative results were compared. The overall 30-day mortality for the entire study cohort was calculated by the GERAADA score to be 22.94% (range, 5.8 to 81%). In comparison, the actual 30-day mortality rate of the study cohort was 32.55%. The GERAADA score showed discriminative power with an area under the curve of 0.867 (95% confidence interval 0.79-0.94).
The GERAADA score prediction of 30-day mortality after surgery is accurate, easily accessible due to its web-based platform, and can be calculated with basic preoperative clinical parameters.
本研究旨在评估德国A型急性主动脉夹层登记系统（GERAADA）评分在预测急性A型主动脉夹层（ATAAD）手术死亡率方面的表现。
这项回顾性研究纳入了2013年1月至2023年12月期间连续接受ATAAD手术修复的86例患者（60例男性，26例女性；平均年龄：61.37±12.96岁）。数据收集包括计算新的GERAADA评分所需的11个术前主要参数：年龄、性别、既往心脏手术史、转诊时的血管活性药物支持、术前复苏、主动脉瓣反流、偏瘫、转诊时的插管/通气、术前器官灌注不良、主动脉夹层的扩展以及原发入口部位的位置。
2例（2.3%）患者有既往心脏手术史。比较了GERAADA评分和术后结果。整个研究队列的30天总死亡率通过GERAADA评分计算为22.94%（范围，5.8%至81%）。相比之下，研究队列的实际30天死亡率为32.55%。GERAADA评分显示出判别能力，曲线下面积为0.867（95%置信区间0.79 - 0.94）。
GERAADA评分对术后30天死亡率的预测准确，由于其基于网络的平台而易于获取，并且可以通过基本的术前临床参数进行计算。
