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

Description

Rampoldi et al reported 2 models for evaluating a patient with acute type A aortic dissection. One of these models is for preoperative 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, prior to 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) preoperative cardiac tamponade

(6) any pulse deficit

(7) infarct or ischemia on ECG (new Q wave, ST elevation)

Parameter	Finding	Points
age in years	< 70 years	0
	>= 70 years	0.7
history AVR	no	0
	yes	1.5
hypotension, shock, or tamponade	no	0
	yes	1.2
migrating chest pain	no	0
	yes	0.9
preoperative cardiac tamponade	no	0
	yes	1.0
any pulse deficit	no	0
	yes	0.6
ECG changes	no	0
	yes	0.6

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: 0

• maximum score: 6.5

probability of mortality =

= (-0.9483 * ((score)^3)) + (8.549 * ((score)^2)) - (2.902 * (score)) +0.6949

Performance:

• The area under the ROC curve is 0.76.

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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): Preoperative Model

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