Clinical predictive value of the age, creatinine, and ejection fraction score in patients in acute type A aortic dissection after total arch replacement.

Autor: Lin XF; Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Xinquan Road 29, Fuzhou, 350001, Fujian, People's Republic of China.; Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, Fujian, People's Republic of China.; Fujian Provincial Center for Cardiovascular Medicine, Fuzhou, Fujian, People's Republic of China., Xie LF; Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Xinquan Road 29, Fuzhou, 350001, Fujian, People's Republic of China.; Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, Fujian, People's Republic of China.; Fujian Provincial Center for Cardiovascular Medicine, Fuzhou, Fujian, People's Republic of China., Zhang ZF; Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Xinquan Road 29, Fuzhou, 350001, Fujian, People's Republic of China.; Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, Fujian, People's Republic of China.; Fujian Provincial Center for Cardiovascular Medicine, Fuzhou, Fujian, People's Republic of China., Wu QS; Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Xinquan Road 29, Fuzhou, 350001, Fujian, People's Republic of China.; Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, Fujian, People's Republic of China.; Fujian Provincial Center for Cardiovascular Medicine, Fuzhou, Fujian, People's Republic of China., Qiu ZH; Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Xinquan Road 29, Fuzhou, 350001, Fujian, People's Republic of China. qzhflm@126.com.; Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, Fujian, People's Republic of China. qzhflm@126.com.; Fujian Provincial Center for Cardiovascular Medicine, Fuzhou, Fujian, People's Republic of China. qzhflm@126.com., Chen LW; Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Xinquan Road 29, Fuzhou, 350001, Fujian, People's Republic of China. chenliangwan@tom.com.; Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, Fujian, People's Republic of China. chenliangwan@tom.com.; Fujian Provincial Center for Cardiovascular Medicine, Fuzhou, Fujian, People's Republic of China. chenliangwan@tom.com.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 May 11; Vol. 14 (1), pp. 10776. Date of Electronic Publication: 2024 May 11.
DOI: 10.1038/s41598-024-58608-4
Abstrakt: The age, creatinine, and ejection fraction (ACEF) score has been accepted as a predictor of poor outcome in elective operations. This study aimed to investigate the predictive value of ACEF score in acute type A aortic dissection (AAAD) patients after total arch replacement. A total of 227 AAAD patients from July 2021 and June 2022 were enrolled and divided into Tertiles 1 (ACEF ≤ 0.73), Tertiles 2 (0.73 < ACEF ≤ 0.95), and Tertiles 3 (ACEF > 0.95). Using inverse probability processing weighting (IPTW) to balance the baseline characteristics and compare the outcomes. Cox logistic regression was used to further evaluate the survival prediction ability of ACEF score. The in-hospital mortality was 9.8%. After IPTW, in the baseline characteristics reached an equilibrium, a higher ACEF score before operation still associated with higher in-hospital mortality. After 1 year follow-up, 184 patients (90.6%) survival. Multivariable analysis revealed that ACEF score (adjusted hazard ratio  1.68; 95% confidence interval 1.34-4.91; p = 0.036) and binary ACEF score (adjusted HR 2.26; 95% CI 1.82-6.20; p < 0.001) was independently associated with 1-year survival. In addition, net reclassification improvement (NRI) and integrated differentiation improvement (IDI) verified that the ACEF score and binary ACEF score is an accurate predictive tool in clinical settings. In conclusions, ACEF score could be considered as a useful tool to risk stratification in patients with AAAD before operation in daily clinical work.
(© 2024. The Author(s).)
Databáze: MEDLINE
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