Analysis of early in-hospital mortality risk factors in patients with Stanford type A aortic dissection involving coronary arteries after surgery

Background: To identify the risk factors associated with early in-hospital mortality in patients with Stanford Type A Aortic Dissection (ATAAD) involving the coronary arteries after surgical intervention. Methods: We retrospectively analyzed data from 74 patients diagnosed with ATAAD involving coronary arteries treated at our hospital between August 2018 and March 2024. They were categorized into two groups: a survival group (n = 30) and a mortality group (n = 44) based on their outcomes at discharge. Multivariate logistic regression analysis was performed to identify independent risk factors for early in-hospital mortality, based on which a diagnostic model was developed. Results: Independent risk factors for early in-hospital mortality included ascending aortic diameter (in mm), duration of ventilator use (≥96 hours), postoperative aspartate aminotransferase (AST) levels (in U/L), high-sensitivity troponin levels >2000 ng/L and the occurrence of malignant arrhythmia. The diagnostic model based on these factors exhibited excellent predictive performance, with an area under the curve (AUC) of 0.945, sensitivity of 88.6% and specificity of 93.3%. Additionally, the calibration plot demonstrated high consistency between predicted and observed outcomes. Conclusions: The proposed diagnostic model, using five key factors: ascending aortic diameter, duration of ventilator use, postoperative AST levels, high-sensitivity troponin levels and malignant arrhythmia, could be promising for predicting early in-hospital mortality in patients with ATAAD involving coronary arteries after surgery.