Work

Validation of the GERAADA Score for Predicting 30‐Day Mortality Rate in Acute Type A Aortic Dissection: A Single‐Center Study in China

Year: 2025

Type: article

Abstract: BACKGROUND: This study aimed to validate the predictive performance of the GERAADA (German Registry for Acute Type A Aortic Dissection) score in predicting 30-day mortality rate in patients with acute type A aortic dissection in China. METHODS: We retrospectively analyzed 526 patients who underwent surgical treatment for acute type A aortic dissection at our institution between 2018 and 2021. The predictive performance of the GERAADA score was evaluated using calibration (observed-to-expected ratio and Hosmer-Lemeshow test) and discrimination (area under the receiver operating characteristic curve). Logistic regression analysis was performed to identify risk factors of 30-day mortality rate. Stratified analyses were conducted to assess performance across different risk categories. RESULTS: =0.461) and discriminative power (area under the receiver operating characteristic curve=0.863). Low-risk patients (score <20; 78.7% of cohort) had a mortality rate of 2.4%, while high-risk patients (score ≥20) showed mortality rates aligning with predicted values (observed-to-expected ratio=1.2). Patients with preoperative critical conditions or end-organ malperfusion exhibited a significantly higher mortality rate. Furthermore, we identified independent risk factors beyond the GERAADA scoring system, and these factors exhibited significant differences between high- and low-risk patients. To address these findings, we developed a mortality risk assessment strategy based on GERAADA score, which further stratifies patients according to their specific clinical characteristics, serving as an optimization and expansion of the GERAADA score. CONCLUSIONS: This study validated the GERAADA score in China for predicting mortality risk in patients with acute type A aortic dissection, showing strong performance in discrimination and calibration. We also developed a mortality risk assessment strategy based on the GERAADA score, offering a practical framework for clinical use. The modular design allows for easy adaptation across centers, although further multicenter studies are needed to confirm its generalizability.

Source: Journal of the American Heart Association

DOI: 10.1161/jaha.125.040838

Authors: Xin‐Fan Lin, Hang‐Qi Gao, Qing‐Song Wu, Yu‐Ling Xie, Liang‐Wan Chen, Lin‐Feng Xie

Institution: Union Hospital

Language: English

Topic: Aortic Disease and Treatment Approaches

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,810