A nomogram for predicting in-hospital mortality in acute type A aortic dissection patients

Although there are several biomarkers for identifying in-hospital mortality in acute type A aortic dissection (AAD), timely as well as perfect prediction in-hospital mortality is still not attained. Herein, we intend to develop as well to validate an in-hospital mortality risk independent predictive nomogram for AAD patients.

From January 2014 to December 2018, 703 individuals with AAD were involved in this study. They were indiscriminately categorized into training (n=520) and validation (n=183) sets. The univariate and multivariate analyses were used to screen in-hospital mortality predictors from the entire training set data. The predictors were used to establish a nomogram which was confirmed via internal as well as external authentication. This validation included discriminative capacity defined by the receiver operating characteristic (ROC) curve area under the curve (AUC) and the predictive precision via calibration curves.

There was 33.43% in-hospital mortality overall incidence. The uric acid, D-dimer, C-reactive protein and management were individually related to in-hospital mortality as per multivariate logistic regression. On the basis of four variables with internal of AUC 0.901 and external validation of AUC 0.903, a nomogram was established. Calibration plots showed that the predicted and actual in-hospital mortality probabilities were fitted well on both internal and external validation.

This recommended nomogram can calculate the specific possibility of in-hospital mortality with good precision, high discrimination, and probable clinical application in AAD patients.