Impact of GERAADA score in patients with acute type A aortic dissection

Kayo Sugiyama; Hirotaka Watanuki; Masato Tochii; Yasuhiro Futamura; Yuka Kitagawa; Satoshi Makino; Wataru Ohashi; Katsuhiko Matsuyama

doi:10.1186/s13019-022-01858-y

Impact of GERAADA score in patients with acute type A aortic dissection

J Cardiothorac Surg. 2022 May 23;17(1):127. doi: 10.1186/s13019-022-01858-y.

Authors

Kayo Sugiyama¹, Hirotaka Watanuki², Masato Tochii², Yasuhiro Futamura², Yuka Kitagawa², Satoshi Makino², Wataru Ohashi³, Katsuhiko Matsuyama²

Affiliations

¹ Department of Cardiac Surgery, Aichi Medical University Hospital, 1-1 Yazako Karimata, Nagakute, Aichi, 480-1195, Japan. kayotaro3@gmail.com.
² Department of Cardiac Surgery, Aichi Medical University Hospital, 1-1 Yazako Karimata, Nagakute, Aichi, 480-1195, Japan.
³ Clinical Research Center, Aichi Medical University Hospital, 1-1 Yazako Karimata, Nagakute, Aichi, 480-1195, Japan.

Abstract

Background: Despite continuous developments and advances in the perioperative management of patients suffering from acute aortic dissection type A (AADA), the associated postoperative morbidity and mortality remain high and strongly depend on the preoperative clinical status. The associated postoperative mortality is still hard to predict prior to the surgical procedure. The so-called German Registry of Acute Aortic Dissection Type A (GERAADA) score uses very basic and easily retrievable parameters and was specifically designed for predicting the 30-day mortality rate in patients undergoing surgery for AADA. This study evaluated impact of the GERAADA score in the authors' institutional results.

Methods: Among 101 acute type A aortic dissection patients treated at our hospital during August 2015-March 2021, the GERAADA was calculated individually and retrospectively. Predicted and actual mortalities were assessed, and independent predicted factors were searched. The primary endpoint was defined as comparison of GERAADA scores and early mortality, and the secondary endpoints were defined as comparison of GERAADA scores and other postoperative results, and comparison of preoperative factors and postoperative results regardless to GERAADA scores.

Results: While the overall 30-day mortality for the entire study cohort calculated by the GERAADA score was 14.3 (8.1-77.6)%, the actual mortality rate was 6%. However, the GERAADA score was significantly high in some postoperative complications and showed significant correlation with some peri- and post-operative factors. In addition, factors not belonging to GERAADA score such as time from onset to arrival at the hospital, time from onset to arrival at the operation room, spouse presence, and hemodialysis were significantly associated with 30-day mortality.

Conclusions: Although the actual mortality was lower than predicted, GERAADA score may impact on the postoperative course. In addition, it would be desirable to add parameters such as the time from onset to arrival, family background, and hemodialysis for further accuracy.

Keywords: Acute aortic dissection type A; GERAADA score; Hemodialysis; Spouse presence.

MeSH terms

Acute Disease
Aortic Dissection* / surgery
Hospital Mortality
Humans
Postoperative Complications
Registries
Retrospective Studies
Risk Factors
Treatment Outcome