Martin Czerny1,2, Matthias Siepe1,2, Friedhelm Beyersdorf1,2, Manuel Feisst3, Michael Gabel3, Maximilian Pilz3, Jochen Pöling4, Daniel-Sebastian Dohle5, Konstantinos Sarvanakis6, Maximilian Luehr7, Christian Hagl7, Arif Rawa8, Wilke Schneider9, Christian Detter10, Tomas Holubec11, Michael Borger12, Andreas Böning13, Bartosz Rylski1,2. 1. Department of Cardiovascular Surgery, University Heart Center Freiburg, Bad Krozingen, Germany. 2. Faculty of Medicine, Albert Ludwigs University Freiburg, Freiburg, Germany. 3. Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany. 4. Department of Cardiac Surgery, Schuechtermann Clinic, Bad Rothenfelde, Germany. 5. Department of Cardiothoracic and Vascular Surgery, University Hospital, Johannes Gutenberg University, Mainz, Germany. 6. Clinic of Cardiothoracic Surgery, Klinikum Augsburg, Augsburg, Germany. 7. Department of Cardiac Surgery, University Hospital, LMU Munich, Munich, Germany. 8. Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany. 9. Department for Thoracic and Cardiovascular Surgery, University Hospital Tübingen, Eberhard Karls University, Tübingen, Germany. 10. Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany. 11. Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Frankfurt/Main, Germany. 12. Department of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany. 13. Department of Adult and Pediatric Cardiovascular Surgery, Giessen University Hospital, Giessen, Germany.
Abstract
OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors: Mikko Jormalainen; Risto Kesävuori; Peter Raivio; Antti Vento; Caius Mustonen; Hannu-Pekka Honkanen; Stefano Rosato; Jarmo Simpanen; Kari Teittinen; Fausto Biancari; Tatu Juvonen Journal: Interact Cardiovasc Thorac Surg Date: 2022-02-21
Authors: Kambiz Hassan; Tabea Brüning; Michael Caspary; Peter Wohlmuth; Holger Pioch; Michael Schmoeckel; Stephan Geidel Journal: Ann Thorac Cardiovasc Surg Date: 2022-01-20 Impact factor: 1.889