title: Utility of Established Risk Models to Predict Surgical Mortality in Acute Type-A Aortic Dissection.
abstract: OBJECTIVE
  The objective of this study was to determine the predictive value of 2 established risk models for surgical mortality in a contemporary cohort of patients undergoing repair of acute type-A aortic dissection.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Single tertiary care hospital.
  
  
  METHODS
  Seventy-nine consecutive patients undergoing emergent repair of acute type-A aortic dissection between 2008 and 2013.
  
  
  METHODS
  All patients underwent emergent repair of acute type-A aortic dissection.
  
  
  RESULTS
  The receiver operating characteristic curve was compared for each scoring system. Of the 79 patients undergoing emergent repair of acute type-A aortic dissection, 23 (29.1%) were above the age of 70. Seventeen (21.5%) patients presented with hypotension, 25 (31.6%) presented with limb ischemia, and 10 (12.7%) presented with evidence of visceral ischemia. Overall operative mortality was 16.5%. Increasing age was the only preoperative variable associated with increased operative mortality. The areas under the receiver operating characteristic curve for operative mortality was 0.62 and 0.66 for the scoring systems developed by Rampoldi et al and Centofanti et al, respectively. The area under the receiver operating characteristic curve for operative mortality for age was 0.67. The areas under the receiver operating characteristic curve for operative mortality between the 2 scoring systems and for age were not statistically different.
  
  
  CONCLUSIONS
  Existing predictive risk models for acute type-A aortic dissection provide moderate discriminatory power for operative mortality. Age as a single variable may provide equivalent discriminatory power for operative mortality as the established risk models.
authors.affiliation: Hofstra North Shore - LIJ School of Medicine, Hempstead, NY.
authors.forename: Pey-Jen
authors.initials: PJ
authors.lastname: Yu
authors.affiliation: Hofstra North Shore - LIJ School of Medicine, Hempstead, NY.
authors.forename: Hugh A
authors.initials: HA
authors.lastname: Cassiere
authors.affiliation: Feinstein Institute for Medical Research, Manhasset, NY.
authors.forename: Nina
authors.initials: N
authors.lastname: Kohn
authors.affiliation: Hofstra North Shore - LIJ School of Medicine, Hempstead, NY.
authors.forename: Sophia L
authors.initials: SL
authors.lastname: Dellis
authors.affiliation: Hofstra North Shore - LIJ School of Medicine, Hempstead, NY.
authors.forename: Frank
authors.initials: F
authors.lastname: Manetta
authors.affiliation: Hofstra North Shore - LIJ School of Medicine, Hempstead, NY.
authors.forename: Rick A
authors.initials: RA
authors.lastname: Esposito
authors.affiliation: Hofstra North Shore - LIJ School of Medicine, Hempstead, NY.
authors.forename: Alan R
authors.initials: AR
authors.lastname: Hartman
mesh_terms: D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: cardiac surgery; dissecting aneurysm; mortality; risk models; type-A