A Model to Predict in-Hospital Death in Patients with Type B Acute Aortic Dissection: A Single-Center Retrospective Observational Study

The Prognostic Value of a Model in BAAD Patients

Authors

  • Wang Li Department of Laboratory Medicine, Taizhou People’s Hospital Affiliated to Nanjing Medical University, Jiangsu, China
  • Jun Zhou Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
  • Cheng Cheng

DOI:

https://doi.org/10.1532/hsf.4779

Keywords:

acute type B aortic dissection, in-hospital mortality

Abstract

Background: Acute type B aortic dissection (BAAD), as a catastrophic disease, is linked to high morbidity and mortality. The current research is to create a simple risk model to predict in-hospital mortality in BAAD patients based on laboratory results.

Methods: Patients with BAAD were included from April 1, 2017, to November 30, 2019, in the hospital. Clinical features and laboratory results were collected. Logistic regression analyses and ROC were applied to the evaluation.

Results: Hemoglobin (HB) (114.88 ± 28.42 (nonsurvivor) vs. 134.95 ± 17.88 (survivor), P < 0.001) and UREA (10.93 ± 7.02 (nonsurvivor) vs. 7.17 ± 3.77 (survivor), P = 0.001) were significantly different. In multivariate analysis, HB (hazard ratio (HR): 0.124; 95% confidence interval (CI) 0.025 – 0.627; P = 0.012) and UREA (HR: 8.765; 95% CI 2.022 – 37.993; P = 0.004) were independent predictors of in-hospital death. Then, a model with good performance (AUC 0.761 (0.677 – 0.832) was developed.

Conclusion: A simple model with good prediction value was developed. With this model, physicians quickly can identify high-risk patients, determine the best treatment strategies, and improve prognosis.

References

Brunkwall J, Lammer J, Verhoeven E, Taylor P. 2012. ADSORB: a study on the efficacy of endovascular grafting in uncomplicated acute dissection of the descending aorta. Eur J Vasc Endovasc Surg. 44(1):31-36.

Cook DJ, Walter SD, Cook RJ, Griffith LE, Guyatt GH, Leasa D, et al. 1998. Incidence of and risk factors for ventilator-associated pneumonia in critically ill patients. Ann Intern Med. 129(6):433-440.

Guo X, Zhao G. 2022. Establishment and Verification of Logistic Regression Model for Qualitative Diagnosis of Ovarian Cancer Based on MRI and Ultrasound Signs. Comput Math Methods Med. 2022:7531371.

Horiuchi Y, Aoki J, Tanabe K, Nakao K, Ozaki Y, Kimura K, et al. 2018. A High Level of Blood Urea Nitrogen Is a Significant Predictor for In-hospital Mortality in Patients with Acute Myocardial Infarction. Int Heart J. 59(2):263-271.

Ko T, Higashitani M, Sato A, Uemura Y, Norimatsu T, Mahara K, et al. 2015. Impact of Acute Kidney Injury on Early to Long-Term Outcomes in Patients Who Underwent Surgery for Type A Acute Aortic Dissection. Am J Cardiol. 116(3):463-468.

Liu J, Sun LL, Wang J, Ji G. 2018. Blood urea nitrogen in the prediction of in-hospital mortality of patients with acute aortic dissection. Cardiol J. 25(3):371-376.

Liu Y, Zhao J, Li F, Sun H, Sun Y, Sun H, et al. 2022. Predictive value of hemoglobin level on early neurological outcomes in acute ischemic stroke. Neurol Res. 1-8.

Ren X, Qu W, Zhang L, Liu M, Gao X, Gao Y, et al. 2018. Role of blood urea nitrogen in predicting the post-discharge prognosis in elderly patients with acute decompensated heart failure. Sci Rep. 8(1):13507.

Sissala N, Mustaniemi S, Kajantie E, Vaarasmaki M, Koivunen P. 2022. Higher hemoglobin levels are an independent risk factor for gestational diabetes. Sci Rep. 12(1):1686.

Surme S, Tuncer G, Bayramlar OF, Copur B, Zerdali E, Nakir IY, et al. 2022. Novel biomarker-based score (SAD-60) for predicting mortality in patients with COVID-19 pneumonia: a multicenter retrospective cohort of 1013 patients. Biomark Med.

Tatlisu MA, Kaya A, Keskin M, Avsar S, Bozbay M, Tatlisu K, et al. 2017. The association of blood urea nitrogen levels with mortality in acute pulmonary embolism. J Crit Care. 39:248-253.

Tolenaar JL, Froehlich W, Jonker FH, Upchurch GR, Jr., Rampoldi V, Tsai TT, et al. 2014. Predicting in-hospital mortality in acute type B aortic dissection: evidence from International Registry of Acute Aortic Dissection. Circulation. 130(11 Suppl 1):S45-50.

Tolenaar JL, Hutchison SJ, Montgomery D, O'Gara P, Fattori R, Pyeritz RE, et al. 2013. Painless Type B Aortic Dissection: Insights From the International Registry of Acute Aortic Dissection. Aorta (Stamford). 1(2):96-101.

Tseng SH, Lee WJ, Peng LN, Lin MH, Chen LK. 2021. Associations between hemoglobin levels and sarcopenia and its components: Results from the I-Lan longitudinal study. Exp Gerontol. 150:111379.

Wilkinson DA, Patel HJ, Williams DM, Dasika NL, Deeb GM. 2013. Early open and endovascular thoracic aortic repair for complicated type B aortic dissection. Ann Thorac Surg. 96(1):23-30; discussion 230.

Zeng R, Li D, Deng L, He Y, Sun X, Wan Z, et al. 2016. Hypoalbuminemia predicts clinical outcome in patients with type B acute aortic dissection after endovascular therapy. Am J Emerg Med. 34(8):1369-1372.

Zhang J, Cheng B, Yang M, Pan J, Feng J, Cheng Z. 2019. Predicting in-hospital death in patients with type B acute aortic dissection. Medicine (Baltimore). 98(32):e16462.

Zhou D, Deng LJ, Ling YF, Tang ML. 2021. Preoperative Hemoglobin Level, Oxygen Saturation and Postoperative Outcomes in Children With Cyanotic Congenital Heart Disease: A Propensity-Score Matching Analysis. Front Pediatr. 9:762241.

Published

2022-07-12

How to Cite

Li, W., zhou, jun, & Cheng, C. (2022). A Model to Predict in-Hospital Death in Patients with Type B Acute Aortic Dissection: A Single-Center Retrospective Observational Study: The Prognostic Value of a Model in BAAD Patients. The Heart Surgery Forum, 25(4), E500-E503. https://doi.org/10.1532/hsf.4779

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