Wang et al reported a model for predicting in-hospital death for a patient with acute aortic syndrome. This can help to identify a patient who will require more aggressive management. The authors are from Peking University, Shanxi Medical University, Zhengzhou University, and affiliated hospitals in China.
Patient selection: acute aortic syndrome
Conditions constituting acute aortic syndrome:
(1) aortic dissection
(2) intramural hematoma
(3) penetrating atherosclerotic aortic disease
(4) thoracic aortic rupture
Parameters:
(1) pulse deficit
(2) digestive system symptoms
(3) serum creatinine i µmol/L
(4) disease extension to iliac arteries
(5) pericardial effusion
(6) Stanford Type A dissection
points for serum creatinine =
= 0.05556 * (creatinine)
|
Parameter
|
Finding
|
Points
|
|
pulse deficit
|
none
|
0
|
|
|
any
|
58.2
|
|
digestive system symptoms
|
none
|
0
|
|
|
any
|
22.8
|
|
iliac artery involvement
|
no
|
0
|
|
|
yes
|
42.7
|
|
pericardial effusion
|
no
|
0
|
|
|
yes
|
27.5
|
|
Stanford Type A dissection
|
no
|
0
|
|
|
yes
|
66.5
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 317.6
value of X =
= (0.03519 * (score)) - 6.367
probability of in-hospital death =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.84 in the development and 0.82 in the validation cohorts.
