Predictive Factors for In-Hospital Preoperative Rupture in Hyperacute Type A Aortic Dissection

Predictors for in-hospital rupture of haTAAD

Authors

  • Xinlong Tang Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing China
  • Yi Jiang Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing China
  • Yunxing Xue Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing China
  • Wei Chen Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing China
  • Haitao Zhang Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing China
  • Yuzhou Lu Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing China
  • He Zhang Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing China
  • Wei Xie Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing China
  • Bo Dai Institute of Cardiothoracic Vascular Disease, Nanjing University, Nanjing China
  • Qing Zhou Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing China
  • Jun Pan Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing China
  • Dongjin Wang Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing China

DOI:

https://doi.org/10.1532/hsf.3765

Keywords:

Aortic dissection, in-hospital rupture, nomogram

Abstract

Objective: This study aims to figure out risk factors of in-hospital preoperative rupture of hyperacute type A aortic dissection (haTAAD) patients and build a prediction and risk stratification model.

Methods: From January 2011 to December 2019, 830 patients diagnosed as haTAAD from Nanjing Drum Tower Hospital were enrolled. Among them, 799 patients received prompt surgery and 31 suffered aortic rupture before operation. The association between in-hospital preoperative rupture and perioperative parameters were examined. Best subset selection was used for feature selection and ROC curve was used to identify the model.

Results: Age, winter season, back pain, preoperative hypotension, albumin and globulin ratio, high serum phosphorus level are risk factors for in-hospital preoperative rupture of haTAAD. On the basis of six variables with AUC 0.828, a nomogram was established. According to the robustness test, actual in-hospital preoperative ruptures were fitted well.

Conclusions: The in-hospital rupture prediction model was developed using logistic regression analysis. High serum phosphorus level is one of the strongest predictors. This nomogram may be useful when evaluating the risk of aortic dissection in-hospital rupture in future trials.

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Published

2021-04-23

How to Cite

Tang, X., Jiang, Y., Xue, Y., Chen, W., Zhang, H., Lu, Y., Zhang, H., Xie, W., Dai, B., Zhou, Q., Pan, J., & Wang, D. (2021). Predictive Factors for In-Hospital Preoperative Rupture in Hyperacute Type A Aortic Dissection: Predictors for in-hospital rupture of haTAAD. The Heart Surgery Forum, 24(2), E379-E386. https://doi.org/10.1532/hsf.3765

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