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Updated: Jan 9, 2026

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
06:26

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Published on: March 28, 2025

811

Dynamic Modified Early Warning Score for predicting postoperative mortality in acute type A aortic dissection: a

Xiluan Li1, Yongquan Zhang2, Yequn Chen3

  • 1Department of Nursing, The First Affiliated Hospital of Shantou University Medical College, Shantou, China.

Journal of Thoracic Disease
|December 11, 2025
PubMed
Abstract

Insights

The Modified Early Warning Score (MEWS) reliably predicts mortality after acute type A aortic dissection (AAAD) surgery. Persistently high MEWS scores indicate increased mortality risk, aiding early patient management.

Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Critical Care Medicine

Background:

  • The Modified Early Warning Score (MEWS) is underutilized in predicting outcomes for acute type A aortic dissection (AAAD).
  • Early identification of mortality risk in AAAD patients is crucial for timely intervention.
  • Understanding MEWS dynamics post-surgery can improve patient stratification.

Purpose of the Study:

  • To assess the predictive accuracy of MEWS at various postoperative time points in AAAD patients.
  • To explore the relationship between MEWS trajectories and in-hospital mortality.
  • To validate MEWS as a tool for risk stratification in AAAD surgery.

Main Methods:

  • Retrospective analysis of 279 AAAD patients undergoing surgery (January 2020 - December 2022).
  • MEWS calculated hourly for the first 24 hours post-surgery.
  • Receiver operating characteristic (ROC) curves and latent class growth modeling (LCGM) used for analysis.

Main Results:

  • In-hospital mortality rate was 13.3% among the 279 patients.
  • Higher MEWS scores consistently correlated with increased mortality (P<0.05).
  • MEWS at 12 hours post-surgery showed the highest predictive accuracy (AUC=0.758, cutoff=4); high-risk MEWS trajectories predicted 45.9% mortality.

Conclusions:

  • MEWS serves as a dependable early predictor of postoperative mortality in AAAD.
  • Sustained elevated MEWS trajectories are strongly linked to higher mortality risks.
  • MEWS facilitates early risk stratification and enhances postoperative management strategies for AAAD patients.
Keywords:
Acute type A aortic dissection (AAAD)Modified Early Warning Score (MEWS)mortalitypostoperativepredicting

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