期刊
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
卷 59, 期 5, 页码 1109-1114出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/ejcts/ezaa455
关键词
Acute type A aortic dissection; Risk score; Aortic surgery
The GERAADA score accurately predicts 30-day mortality in AADA patients, including all subgroups in the study. Preoperative resuscitation, advanced age, and other/unknown malperfusion were identified as independent risk factors.
OBJECTIVES: The German Registry of Acute Aortic Dissection Type A (GERAADA) score to predict 30-day mortality in patients suffering from acute aortic dissection type A (AADA) was recently introduced. The aim of this study was to evaluate if the GERAADA score's prediction corresponds with the authors' institutional results. METHODS: All consecutive AADA patients between 2010 and 2020 were included. Retrospective data collection comprised 11 preoperative parameters: age, sex, previous cardiac surgery, inotropic support at referral, resuscitation before surgery, aortic regurgitation, preoperative hemiparesis, intubation/ventilation at referral, preoperative organ malperfusion, extension of aortic dissection and location of primary entry site. Calculations of the GERAADA score were individually performed by a cardiac surgeon blinded to the study for all patients via a web-based application (https://www.dgthg.de/de/GERAADA_Score). RESULTS: A total of 371 AADA patients were operated at the authors' institution. The mean age was 62.7 +/- 13.5 years and 233 (63%) were males. Prediction of 30-day mortality was accurate for the entire study cohort (actual vs predicted 30-day mortality: 15.1% vs 15.7%; P = 0.776) as well as for all 26 subgroups. In addition, preoperative resuscitation (P < 0.001), advanced age (P = 0.042) and other/unknown malperfusion (P = 0.032) were identified as independent risk factors. CONCLUSIONS: 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 very basic preoperative clinical parameters. A prospective clinical trial is required to further evaluate the new GERAADA score as a useful tool to allow for improved decision-making in the emergency setting of AADA.
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