Assessment of Shock Index and Glucose/Potassium Ratio for Early Mortality Prediction in Acute Type A Aortic Dissection

Aim: Acute Type A Dissection (ATAD) is a critical medical condition requiring prompt surgical intervention. The risk of mortality escalates with each hour following diagnosis, highlighting the importance of expeditious treatment. This retrospective cohort study, encompassing 117 ATAD patients over the period from March 2019 to June 2023 at a leading cardiovascular surgery clinic, explores the potential of Shock Index (SI) and Glucose/Potassium Ratio (GPR) as prognostic indicators for early mortality in the preoperative phase. Material and Methods: Demographic, clinical, and surgical data were gathered from hospital records. Both SI (calculated as heart rate/systolic blood pressure) and GPR (calculated as glucose/potassium) were recorded at admission. Their associations with postoperative mortality and morbidity were examined. Results: The cohort's mortality rate was at 27.3%, with a noteworthy elevation in GPR observed in the mortality group. While the Shock Index displayed a numerical increase in the mortality group, the disparity did not achieve statistical significance. Optimal GPR cut-off for mortality prediction was identified as 28.7, sensitivity of 0.68 and specificity of 0.64. GPR surpassed SI in predicting mortality, demonstrating an Area Under the Curve (AUC) of 0.67. Conclusion: In the critical context of ATAD, where time plays a decisive role, the Shock Index may not offer optimal accuracy in predicting early mortality. Conversely, the Glucose/Potassium Ratio emerges as a valuable and expeditious tool for anticipating mortality and prognosis. This study emphasizing the pivotal role of GPR in predicting postoperative outcomes and guiding clinical decision-making.