Background:

Type A acute aortic dissection (TAAAD) is a destructive cardiovascular disease, with high morbidity and mortality rates. Identifying the high-risk TAAAD patients at an early stage is urgently necessary.

Methods:

A retrospective study of 160 patients was carried out. The admission data were retrospectively gathered. Logistic regression analysis and receiver operator characteristic curve (AUC) was utilized.

Results:

Compared with the survivor group, the nonsurvivor group was older, had higher D-dimer levels, red blood cell distribution width (RDW) levels and platelet distribution width (PDW) levels, and lower fibrinogen levels, platelet levels and plateletcrit levels. Multivariate analysis displayed that four independent factors, age (hazard ratio (HR): 7.877, 95% confidence interval (CI) 2.740–22.641, p < 0.001), D-dimer (HR: 3.791, 95% CI 1.520–9.452, p = 0.004), RDW (HR: 3.300, 95% CI 1.109–9.825, p = 0.032), PDW (HR: 3.755, 95% CI 1.436–9.815, p = 0.007) were incorporated into the model. The predict accuracy of the model (AUC 0.861, 95% CI 0.798–0.911, p < 0.001) was best.

Conclusions:

Age, D-dimer, RDW and PDW are independent markers of in-hospital death in TAAAD patients and the newly established model has better performance in predicting high-risk patients. This model can be used as a quick screening tool to assess the prognosis of patients in individualizing.

中文翻译：

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预测 A 型急性主动脉夹层患者院内死亡的简单模型

背景：

A 型急性主动脉夹层 (TAAAD) 是一种破坏性心血管疾病，具有高发病率和死亡率。迫切需要在早期识别高危 TAAAD 患者。

方法：

对 160 名患者进行了回顾性研究。入院数据是回顾性收集的。使用逻辑回归分析和接受者操作员特征曲线（AUC）。

结果：

与存活组相比，非存活组年龄较大，D-二聚体水平、红细胞分布宽度（RDW）水平和血小板分布宽度（PDW）水平较高，纤维蛋白原水平、血小板水平和血小板压积水平较低。多变量分析显示四个独立因素，年龄（风险比 (HR)：7.877，95% 置信区间 (CI) 2.740–22.641，p < 0.001），D-二聚体（HR：3.791，95% CI 1.520–9.452，p = 0.004），RDW（HR：3.300，95% CI 1.109–9.825，p = 0.032），PDW（HR：3.755，95% CI 1.436–9.815，p = 0.007）被纳入模型。该模型的预测准确性 (AUC 0.861, 95% CI 0.798–0.911, p < 0.001) 是最好的。

结论：

年龄、D-二聚体、RDW和PDW是TAAAD患者院内死亡的独立标志物，新建立的模型在预测高危患者方面表现更好。该模型可作为一种快速筛选工具，用于评估个体化患者的预后。