Prognostic Value of a Composite Inflammation-Renal Function Score in Type A Aortic Dissection

Area of Science:

• Cardiovascular Surgery
• Nephrology
• Inflammatory Medicine

Background:

• Systemic inflammation and renal dysfunction are critical in type A aortic dissection (TAAD) progression and prognosis.
• Existing prognostic models for TAAD may benefit from incorporating novel biomarkers.

Purpose of the Study:

• To evaluate the prognostic value of the SCr score, a composite index of systemic inflammation and serum creatinine, in surgically treated TAAD patients.
• To develop and validate a prognostic nomogram integrating the SCr score for predicting patient outcomes.

Main Methods:

• Retrospective analysis of clinical data from 299 surgically treated TAAD patients.
• Stratification of SCr scores and assessment of survival differences using Kaplan-Meier curves.
• Multivariable regression analyses to identify independent predictors of overall survival and in-hospital mortality; nomogram development and validation.

Main Results:

• Higher SCr scores were significantly associated with increased mortality risk (HR=4.408 for SCr=2).
• The SCr score independently predicted both overall survival and in-hospital mortality (ORs ranging from 3.066 to 4.811).
• A prognostic nomogram incorporating the SCr score demonstrated strong discriminative performance (AUCs of 0.845 for OS and 0.821 for IHM).

Conclusions:

• The SCr score is an independent predictor of preoperative risk in TAAD patients.
• An SCr-based nomogram shows excellent performance in predicting overall survival and in-hospital mortality.
• SCr score assessment offers valuable complementary information for identifying high-risk TAAD patients.