Risk Models of Rampoldi et al for Surgical Mortality in Acute Type A Aortic Dissection (International Registry of Acute Aortic Dissection Score, IRAADS): Intraoperative Model

Description

Rampoldi et al reported 2 models for evaluating a patient with acute type A aortic dissection. One of these models is for intraoperative assessment. The authors are from multiple institutions in Italy, Norway, Germany, and the United States involved with the International Registry of Acute Aortic Dissection.

Patient selection: acute type A aortic dissection, undergoing surgery

Parameters:

(1) age in years

(2) history of aortic valve replacement (AVR)

(3) presentation with hypotension, shock or tamponade

(4) migrating chest pain

(5) any pulse deficit

(6) hypotension or shock during surgery

(7) right ventricular dysfunction during surgery

(8) partial arch replacement during surgery

(9) CABG performed

Parameter	Finding	Points
age in years	< 70 years	0
	>= 70 years	0.6
history AVR	no	0
	yes	1.8
hypotension, shock or tamponade	no	0
	yes	0.9
migrating chest pain	no	0
	yes	0.7
any pulse deficit	no	0
	yes	0.6
hypotension or shock in surgery	no	0
	yes	1.3
RV dysfunction	no	0
	yes	1.6
partial arch	no	0
	yes	-0.7
CABG performed	no	0
	yes	0.9

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: -0.7

• maximum score: 8.4

value of X =

= (-0.1238 * ((score)^2)) + (1.737*(score)) - 4.228

probability of mortality =

= 1 / (1 + EXP((-1) * X))

Performance:

• The area under the ROC curve is 0.81.

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Risk Models of Rampoldi et al for Surgical Mortality in Acute Type A Aortic Dissection (International Registry of Acute Aortic Dissection Score, IRAADS): Intraoperative Model

Description

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