The value of five scoring systems in evaluating the prognosis of perioperative aortic dissection
10.3760/cma.j.cn112434-20241117-00281
- VernacularTitle:5个评分系统在评估围手术期主动脉夹层预后中的价值
- Author:
Chen LI
1
;
Xingping LYU
1
;
Yezhou SHEN
1
;
Xiaobin LIU
1
;
Wei ZHOU
1
;
Guoliang FAN
1
;
Feng ZHU
1
Author Information
1. 同济大学附属东方医院重症医学科，上海 200120
- Publication Type:Journal Article
- Keywords:
Acute Physiology Score Ⅲ;
Oxford Acute Severity of Illness Score;
Sequential Organ Failure Assessment;
Simplified Acute Physiology Score Ⅱ;
Charlson Comor
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(2):91-97
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To determine the best scoring system for assessing the severity of perioperative aortic dissection.Methods:All data were obtained from the Medical Information Mart for Intensive Care-Ⅳ(MIMIC-Ⅳ) database in the United States. The predictive value of the Acute Physiology Score Ⅲ(APS Ⅲ), Oxford Acute Severity of Illness Score (OASIS), Sequential Organ Failure Assessment (SOFA), Simplified Acute Physiology Score Ⅱ(SAPS Ⅱ), and Charlson Comorbidity Index (CCI) scoring systems were evaluated using the receiver operating characteristic ( ROC) curve. The area under the curve ( AUC) was used to determine the best predictive score, and the ideal cutoff value of the score was calculated based on the Youden index. Patients were divided into high and low groups according to the cutoff value. The Kaplan- Meier curve was used to show the impact on the survival rate of patients with aortic dissection. Results:ROC curve analysis showed that APS Ⅲ( AUC: 0.803, 95% CI: 0.721-0.885) was superior to SAPS Ⅱ( AUC: 0.767, 95% CI: 0.654-0.880), OASIS( AUC: 0.760, 95% CI: 0.635-0.885), SOFA( AUC: 0.753, 95% CI: 0.649-0.857), and CCI( AUC: 0.670, 95% CI: 0.524-0.817) in assessing in-hospital mortality. Based on the ROC curve and the Youden index calculation, the ideal cutoff value of the APS Ⅲ score was 57.5. Kaplan- Meier survival analysis showed that patients in the high group of APS Ⅲ had a shorter 28-day survival time. Patients in the high group of APS Ⅲ had a higher incidence of postoperative complications, and correlation analysis showed that patients in the high group of APS Ⅲ had a longer hospital stay. Conclusion:The APS Ⅲ scoring system is more valuable in predicting the 28-day mortality and prognosis of patients with aortic dissection.
