We compared the performance of four existing risk models and a newly developed risk score for type A acute aortic dissection surgery. In 327
consecutives with type A aortic dissection surgery patients during 2003/03-2017/03 at our centre, operative mortality occurred in 65 (19.9%).
Independent predictors of operative mortality were critical pre-operative state and malperfusion syndrome, and a novel additive “CritMal” Score
was constructed from this. C-statistics (95% confidence interval) for operative mortality were EuroSCORE 0.60 (0.52-0.67), EuroSCORE II 0.64
(0.57-0.72), Rampoldi 0.68 (0.59-0.76), Leontyev 0.56 (0.48-0.64), and CritMal 0.72 (0.64-0.80) respectively. This is the first study externally
assessing surgical scores for aortic dissection surgery, with modest accuracy for all and moderate for CritMal. There is room for improvement of
these risk models, and further refinements and external validation are warranted for clinical application.
Managing patients with acute type A aortic dissection and mesenteric malperfusion syndrome: A 20-year experience
