Mortality risk of serum potassium on admission in patients with type A acute aortic dissection

Abstract Background Acute aortic dissection type A is a life-threatening disease required emergency surgery during acute phase. Different clinical manifestations, laboratory tests, and imaging features of patients with acute aortic dissection type A are the risk factors of preoperative mortality. This study aims to establish a simple and effective preoperative mortality risk assessment model for patients with acute aortic dissection type A. Methods A total of 673 Chinese patients with acute aortic dissection type A who were admitted to our hospital were retrospectively included. All patients were unable to receive surgically treatment within 3 days from the onset of disease. The patients included were divided into the survivor and deceased groups, and the endpoint event was preoperative death. Multivariable analysis was used to investigate predictors of preoperative mortality and to develop a prediction model. Results Among the 673 patients, 527 patients survived (78.31%) and 146 patients died (21.69%). The developmental dataset had 505 patients, calibration by Hosmer Lemeshow was significant (χ2 = 3.260, df = 8, P = 0.917) and discrimination by area under ROC curve was 0.8448 (95% CI 0.8007–0.8888). The validation dataset had 168 patients, calibration was significant (χ2 = 5.500, df = 8, P = 0.703) and the area under the ROC curve was 0.8086 (95% CI 0.7291–0.8881). The following independent variables increased preoperative mortality: age (OR = 1.008, P = 0.510), abrupt chest pain (OR = 3.534, P < 0.001), lactic in arterial blood gas ≥ 3 mmol/L (OR = 3.636, P < 0.001), inotropic support (OR = 8.615, P < 0.001), electrocardiographic myocardial ischemia (OR = 3.300, P = 0.001), innominate artery involvement (OR = 1.625, P = 0.104), right common carotid artery involvement (OR = 3.487, P = 0.001), superior mesenteric artery involvement (OR = 2.651, P = 0.001), false lumen / true lumen of ascending aorta ≥ 0.75 (OR = 2.221, P = 0.007). Our data suggest that a simple and effective preoperative death risk assessment model has been established. Conclusions Using a simple and effective risk assessment model can help clinicians quickly identify high-risk patients and make appropriate medical decisions.

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U-shaped relationship between platelet–lymphocyte ratio and postoperative in-hospital mortality in patients with type A acute aortic dissection

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02391-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xi Xie ◽

Xiangjie Fu ◽

Yawen Zhang ◽

Wanting Huang ◽

Lingjin Huang ◽

...

Keyword(s):

Aortic Dissection ◽

Hospital Mortality ◽

Mortality Risk ◽

Acute Aortic Dissection ◽

Inflammatory Marker ◽

Smooth Curve ◽

Type A ◽

Independent Effect ◽

Lymphocyte Ratio ◽

Platelet Lymphocyte Ratio

Abstract Background The platelet-lymphocyte ratio (PLR), a novel inflammatory marker, is generally associated with increased in-hospital mortality risk. We aimed to investigate the association between PLR and postoperative in-hospital mortality risk in patients with type A acute aortic dissection (AAAD). Methods Patients (n = 270) who underwent emergency surgery for AAAD at Xiangya Hospital of Central South University between January 2014 and May 2019 were divided into three PLR-based tertiles. We used multiple regression analyses to evaluate the independent effect of PLR on in-hospital mortality, and smooth curve fitting and a segmented regression model with adjustment of confounding factors to analyze the threshold effect between PLR and in-hospital mortality risk. Results The overall postoperative in-hospital mortality was 13.33%. After adjusting for confounders, in-hospital mortality risk in the medium PLR tertile was the lowest (Odds ratio [OR] = 0.20, 95% confidence interval [CI] = 0.06–0.66). We observed a U-shaped relationship between PLR and in-hospital mortality risk after smoothing spline fitting was applied. When PLR < 108, the in-hospital mortality risk increased by 10% per unit decrease in PLR (OR = 0.90, P = 0.001). When the PLR was between 108 and 188, the mortality risk was the lowest (OR = 1.02, P = 0.288). When PLR > 188, the in-hospital mortality risk increased by 6% per unit increase in PLR (OR = 1.06, P = 0.045). Conclusions There was a U-shaped relationship between PLR and in-hospital mortality in patients with AAAD, with an optimal PLR range for the lowest in-hospital mortality risk of 108–188. PLR may be a useful preoperative prognostic tool for predicting in-hospital mortality risk in patients with AAAD and can ensure risk stratification and early treatment initiation.

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A preoperative mortality risk assessment model for Standford type A acute aortic dissection

10.21203/rs.3.rs-25905/v2 ◽

2020 ◽

Author(s):

Juntao Kuang ◽

Jue Yang ◽

Qiuji Wang ◽

Changjiang Yu ◽

Ying Li ◽

...

Keyword(s):

Risk Assessment ◽

Aortic Dissection ◽

Mortality Risk ◽

Roc Curve ◽

Acute Aortic Dissection ◽

Type A ◽

Assessment Model ◽

Validation Dataset ◽

Risk Assessment Model ◽

Aortic Dissection Type A

Abstract OBJECTIVES Acute aortic dissection type A is a life-threatening disease required emergency surgery during acute phase. Different clinical manifestations, laboratory tests, and imaging features of patients with acute aortic dissection type A are the risk factors of preoperative mortality. This study aims to establish a simple and effective preoperative mortality risk assessment model for patients with acute aortic dissection type A.METHODS A total of 673 Chinese patients with acute aortic dissection type A who were admitted to our hospital were retrospectively included. All patients were unable to receive surgically treatment within 3 days from the onset of disease. The patients included were divided into the survivor and deceased groups, and the endpoint event was preoperative death. Multivariable analysis was used to investigate predictors of preoperative mortality and to develop a prediction model.RESULTS Among the 673 patients, 527 patients survived (78.31%) and 146 patients died (21.69%). The developmental dataset had 505 patients, calibration by Hosmer Lemeshow was significant (χ2 = 3.260, df = 8, P = 0.917) and discrimination by area under ROC curve was 0.8,448 (95% CI, 0.8,007-0.8,888). The validation dataset had 168 patients, calibration was significant (χ2 = 5.500, df = 8, P = 0.703) and the area under the ROC curve was 0.8,086 (95% CI, 0.7,291-0.8,881). The following independent variables increased preoperative mortality: age (OR = 1.008, P = 0.510), abrupt chest pain (OR = 3.534, P < 0.001), lactic in arterial blood gas ≥ 3 mmol/L (OR = 3.636, P < 0.001), inotropic support (OR = 8.615, P < 0.001), electrocardiographic myocardial ischemia (OR = 3.300, P = 0.001), innominate artery involvement (OR = 1.625, P = 0.104), right common carotid artery involvement (OR = 3.487, P = 0.001), superior mesenteric artery involvement (OR = 2.651, P = 0.001), false lumen / true lumen of ascending aorta ≥ 0.75 (OR = 2.221, P = 0.007) . Our data suggest that a simple and effective preoperative death risk assessment model has been established.CONCLUSIONS Using a simple and effective risk assessment model can help clinicians quickly identify high-risk patients and make appropriate medical decisions.

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A preoperative mortality risk assessment model for Standford type A acute aortic dissection

10.21203/rs.3.rs-25905/v1 ◽

2020 ◽

Author(s):

Juntao Kuang ◽

Jue Yang ◽

Qiuji Wang ◽

Changjiang Yu ◽

Ying Li ◽

...

Keyword(s):

Risk Assessment ◽

Aortic Dissection ◽

Mortality Risk ◽

Acute Aortic Dissection ◽

False Lumen ◽

Type A ◽

Assessment Model ◽

Imaging Features ◽

Risk Assessment Model ◽

Aortic Dissection Type A

Abstract OBJECTIVES Acute aortic dissection type A is a life-threatening disease required emergency surgery during acute phase. Different clinical manifestations: laboratory tests: and imaging features of patients with acute aortic dissection type A are the risk factors of preoperative mortality. This study aims to establish a simple and effective preoperative mortality risk assessment model for patients with acute aortic dissection type A. METHODS A total of 508 Chinese patients with acute aortic dissection type A who were admitted to our hospital were retrospectively included. All patients were unable to receive surgically treatment within 3 days from the onset of disease. Multivariable analysis was used to investigate predictors of preoperative mortality and to develop a prediction model. RESULTS Among the 508 patients: 394 patients survived (77.56%) and 114 patients died (22.44%). The following independent variables increased preoperative mortality: initial pain site: chest (OR = 7.536: P = 0.021): D-Dimmer ≥ 12000 ng/ml (OR = 2.982: P < 0.001): the average ascending diameter measured by transthoracic echocardiography ≥ 55 mm (OR = 4.226: P < 0.001): moderate or massive pericardial effusion (OR = 2.534: P = 0.040): electrocardiographic myocardial ischemia (OR = 3.355: P < 0.001): patent false lumen (OR = 2.808: P < 0.001): right common carotid artery involvement (OR = 4.415: P < 0.001): false lumen /true lumen of abdominal aorta ≥ 0.75 (OR = 2.310: P = 0.011). Our data suggest that a simple and effective preoperative death risk assessment model has been established. CONCLUSIONS Using a simple and effective risk assessment model can help clinicians quickly identify high-risk patients and make appropriate medical decisions.

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A preoperative mortality risk assessment model for Stanford type A acute aortic dissection

10.21203/rs.3.rs-25905/v3 ◽

2020 ◽

Author(s):

Juntao Kuang ◽

Jue Yang ◽

Qiuji Wang ◽

Changjiang Yu ◽

Ying Li ◽

...

Keyword(s):

Risk Assessment ◽

Aortic Dissection ◽

Mortality Risk ◽

Roc Curve ◽

Acute Aortic Dissection ◽

Type A ◽

Assessment Model ◽

Validation Dataset ◽

Risk Assessment Model ◽

Aortic Dissection Type A

Abstract BACKGROUNDAcute aortic dissection type A is a life-threatening disease required emergency surgery during acute phase. Different clinical manifestations, laboratory tests, and imaging features of patients with acute aortic dissection type A are the risk factors of preoperative mortality. This study aims to establish a simple and effective preoperative mortality risk assessment model for patients with acute aortic dissection type A.METHODSA total of 673 Chinese patients with acute aortic dissection type A who were admitted to our hospital were retrospectively included. All patients were unable to receive surgically treatment within 3 days from the onset of disease. The patients included were divided into the survivor and deceased groups, and the endpoint event was preoperative death. Multivariable analysis was used to investigate predictors of preoperative mortality and to develop a prediction model.RESULTSAmong the 673 patients, 527 patients survived (78.31%) and 146 patients died (21.69%). The developmental dataset had 505 patients, calibration by Hosmer Lemeshow was significant (χ2 = 3.260, df = 8, P = 0.917) and discrimination by area under ROC curve was 0.8448 (95% CI, 0.8007-0.8888). The validation dataset had 168 patients, calibration was significant (χ2 = 5.500, df = 8, P = 0.703) and the area under the ROC curve was 0.8086 (95% CI, 0.7291-0.8881). The following independent variables increased preoperative mortality: age (OR = 1.008, P = 0.510), abrupt chest pain (OR = 3.534, P < 0.001), lactic in arterial blood gas ≥ 3 mmol/L (OR = 3.636, P < 0.001), inotropic support (OR = 8.615, P < 0.001), electrocardiographic myocardial ischemia (OR = 3.300, P = 0.001), innominate artery involvement (OR = 1.625, P = 0.104), right common carotid artery involvement (OR = 3.487, P = 0.001), superior mesenteric artery involvement (OR = 2.651, P = 0.001), false lumen / true lumen of ascending aorta ≥ 0.75 (OR = 2.221, P = 0.007) . Our data suggest that a simple and effective preoperative death risk assessment model has been established.CONCLUSIONSUsing a simple and effective risk assessment model can help clinicians quickly identify high-risk patients and make appropriate medical decisions.

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