A Predictive Model for Prolonged Mechanical Ventilation After Triple-Branched Stent Graft for Acute Type A Aortic Dissection

Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved..

INTRODUCTION: The aim of this study is to develop a model for predicting the risk of prolonged mechanical ventilation (PMV) following surgical repair of acute type A aortic dissection (AAAD).

METHODS: We retrospectively collected clinical data from 381 patients with AAAD who underwent emergency surgery. Clinical features variables for predicting postoperative PMV were selected through univariate analysis, least absolute shrinkage and selection operator regression analysis, and multivariate logistic regression analysis. A risk prediction model was established using a nomogram. The model's accuracy and reliability were evaluated using the area under the curve of the receiver operating characteristic curve and the calibration curve. Internal validation of the model was performed using bootstrap resampling. The clinical applicability of the model was assessed using decision curve analysis and clinical impact curve.

RESULTS: Among the 381 patients, 199 patients (52.2%) experienced postoperative PMV. The predictive model exhibited good discriminative ability (area under the curve = 0.827, 95% confidence interval: 0.786-0.868, P < 0.05). The calibration curve confirmed that the predicted outcomes of the model closely approximated the ideal curve, indicating agreement between the predicted and actual results (with an average absolute error of 0.01 based on 1000 bootstrap resampling). The decision curve analysis curve demonstrated that the model has significant clinical value.

CONCLUSIONS: The nomogram model established in this study can be used to predict the risk of postoperative PMV in patients with AAAD. It serves as a practical tool to assist clinicians in adjusting treatment strategies promptly and implementing targeted therapeutic measures.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:296

Enthalten in:

The Journal of surgical research - 296(2024) vom: 15. März, Seite 66-77

Sprache:

Englisch

Beteiligte Personen:

Xie, Lin-Feng [VerfasserIn]
Han, Xu [VerfasserIn]
Xie, Yu-Ling [VerfasserIn]
He, Jian [VerfasserIn]
Wu, Qing-Song [VerfasserIn]
Qiu, Zhi-Huang [VerfasserIn]
Chen, Liang-Wan [VerfasserIn]

Links:

Volltext

Themen:

Acute type A aortic dissection
Journal Article
Nomogram
Predictive models
Prolonged mechanical ventilation
Triple-branched stent graft

Anmerkungen:

Date Completed 19.03.2024

Date Revised 19.03.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.jss.2023.12.007

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM367100541