Predicting Death in Patients With Acute

Type A Aortic Dissection

Rajendra H. Mehta, MD, MS; Toru Suzuki, MD; Peter G. Hagan, MD; Eduardo Bossone, MD;
Dan Gilon, MD; Alfredo Llovet, MD; Luis C. Maroto, MD; Jeanna V. Cooper, MS;
Dean E. Smith, PhD; William F. Armstrong, MD; Christoph A. Nienaber, MD; Kim A. Eagle, MD; on
Behalf of the International Registry of Acute Aortic Dissection (IRAD) Investigators

Background—Given the high mortality rates in patients with type A aortic dissection, predictive tools to identify patients
at increased risk of death are needed to assist clinicians for optimal treatment.
Methods and Results—Accordingly, we evaluated 547 patients with this diagnosis enrolled in the International Registry
of Acute Aortic Dissection (IRAD) between January 1996 and December 1999. Univariate testing followed by
multivariate logistic regression analysis was performed to identify independent predictors of death. In-hospital mortality
rate was 32.5% in type A dissection patients. In-hospital complications (neurological deficits, altered mental status,
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myocardial or mesenteric ischemia, kidney failure, hypotension, cardiac tamponade, and limb ischemia) were increased
in patients who died compared with survivors (P⬍0.05 for all). Logistic regression identified the following presenting
variables as predictors of death: age ⱖ70 years (OR, 1.70; 95% CI, 1.05 to 2.77; P⫽0.03), abrupt onset of chest pain
(OR 2.60; 95% CI, 1.22 to 5.54; P⫽0.01), hypotension/shock/tamponade (OR, 2.97; 95% CI, 1.83 to 4.81; P⬍0.0001),
kidney failure (OR, 4.77; 95% CI, 1.80 to 12.6; P⫽0.002), pulse deficit (OR, 2.03; 95% CI, 1.25 to 3.29, P⫽0.004),
and abnormal ECG (OR, 1.77; 95% CI, 1.06 to 2.95; P⫽0.03) (area under receiver operating curve, 0.74;
Hosmer-Lemeshow statistic, P⫽0.75).
Conclusions—The in-hospital mortality rate in acute type A aortic dissection is high and can be predicted with the use of
a clinical model incorporated in a simple risk prediction tool. This tool can be used to educate patients with dissection
about their predicted risk and in clinical research for risk adjustment while comparing outcomes of different therapies.
(Circulation. 2002;105:200-206.)
Key Words: aorta 䡲 mortality 䡲 surgery 䡲 risk factors

A cute type A aortic dissection is a medical emergency

that carries a high mortality rate in absence of surgical
treatment.1–9 Most studies that have evaluated the predictors
of death for patients with aortic dissection were restricted to
a small number of patients at a single center stretching over
a period of years.5,10 –18 Furthermore, these studies have
focused their attention on the surgically treated cohort rather
than all patients with dissection presenting to their institu-
tion.10 –17,19 –21 Most have not distinguished acute from
chronic stable,5,10 –12,14,17,19,21 or type A from B11,14,17,19,21
dissection, conditions that have different natural histories and
call for different treatment strategies. As such, at present, the
predictors of death in large, unselected, consecutive acute
type A aortic dissection patients are not well known.
The International Registry of Acute Aortic Dissection
(IRAD) represents an opportunity to study a large group of
consecutive patients with aortic dissection who presented to
hospitals in a broad geographic region.7 We conducted a
comprehensive analysis of 290 clinical variables and their
relation to in-hospital death to identify independent predictors
of death. Furthermore, with the use of these identifiers, the
goal of this analysis was to create a simple bedside tool that
could be used to predict death.
Methods
International Registry of Acute Aortic Dissection
The inception and structure of IRAD has been described previously.7
In brief, 18 large referral centers in 6 countries agreed to participate
in the ongoing registry, which was established in 1996. The main
purpose of IRAD was to assess the etiological factors, modes of
presentation, clinical features, treatment, and outcome of patients
with aortic dissection in the current era. Beginning January 1, 1996,
consecutive patients with acute aortic dissection (both type A and
type B) presenting to IRAD sites were enrolled in the registry.
Consecutive patients were identified prospectively at presentation or
retrospectively by searching hospital discharge diagnosis records
and/or surgical, pathology, and echocardiography databases. Diag-

Received August 8, 2001; revision received November 2, 2001; accepted November 5, 2001.
From the University of Michigan (R.H.M., P.G.H., J.V.C., D.E., W.F.A., K.A.E.), Ann Arbor; University of Tokyo (T.S.), Japan; Instituto Policlinico
San Donato (E.B.), Milan, Italy; Hadassah University Hospital (D.G.), Jerusalem, Israel; Hospital Universitario “12 de Octubre” (A.L., L.C.M.), Madrid,
Spain; and University of Rostock (C.A.N.), Germany.
Correspondence to Kim A. Eagle, MD, University of Michigan, 3910 TC, Ann Arbor, MI 48109. E-mail keagle@umich.edu
© 2002 American Heart Association, Inc.
Circulation is available at http://www.circulationaha.org

200
 Mehta et al Predicting Death in Type A Aortic Dissection 201

TABLE 1. Demographics and History for Patients With Type A Aortic Dissection
Variable Overall Survived Died P
n (%) 547 (100) 369 (67.5) 178 (32.5)
Demographics
Age, mean⫾SD, y 61.9 (14.1) 60.7 (13.6) 64.4 (14.9) 0.004
Age ⱖ70 y 192 (35.2) 110 (30.0) 82 (46.1) 0.0002
Male 357 (65.5) 255 (69.3) 102 (57.3) 0.006
Transferred to IRAD sites 368 (67.4) 254 (69.0) 114 (64.0) 0.24
Etiology and patient history
Marfan syndrome 31 (5.8) 21 (5.8) 10 (5.9) 0.96
Hypertension 367 (69.4) 254 (70.6) 113 (66.9) 0.39
Atherosclerosis 145 (27.2) 91 (25.1) 54 (31.8) 0.11
Biscuspid aortic valve 15 (5.8) 12 (6.7) 3 (3.9) 0.38
Iatrogenic dissection 33 (6.5) 21 (6.0) 12 (7.4) 0.56
Prior aortic dissection 18 (3.4) 16 (4.4) 2 (1.2) 0.05
Prior aortic aneurysm 66 (12.4) 45 (12.4) 21 (12.5) 0.93
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Diabetes 25 (4.8) 17 (4.8) 8 (4.8) 1.00

Prior cardiac surgery 76 (15.0) 50 (14.5) 26 (16.3) 0.60
Values are n (%).

nosis was suspected on the basis of the history and physical
examination and was confirmed by imaging study findings, visual-
ization at surgery, and/or postmortem examination.
Patient Selection
All patients with acute type A aortic dissection enrolled in IRAD
from January 1, 1996, to December 31, 1999, were included for the
purpose of this analysis. Acute type A dissection was defined as any
dissection that involved the ascending aorta with presentation within
14 days of symptom onset.13,22
Data Collection
Data were assembled with the use of a standardized data form on
patient demographics, history, clinical presentations, physical find-
ings, imaging studies results, details of medical and surgical treat-
ment, and patient outcomes. Completed data entry forms were
forwarded by the participating IRAD sites to the coordinating center
at the University of Michigan. Data forms were reviewed for
analytical internal validity, and external validation was performed
through a random (5%) field selection and error audit. Data were
scanned electronically into an Access database.
Predictive Modeling
Iterative logistic regression modeling for in-hospital death with the
likelihood ratio test used for model selection was performed. Initial
modeling used elements marginally suggestive of an unadjusted
association to in-hospital death (defined as P⬍0.20). Variables were
reviewed for clinical significance before testing. Diagnostic routines
(Hosmer-Lemeshow test for lack of fit, change in deviance, and
likelihood ratio test) were used on final model selection. SAS 8.1
was used for all analyses.
Development of a Simple Bedside Risk
Prediction Tool
The variables found to be significantly associated with in-hospital
death in the “best” regression model were assigned a score equal to
their coefficients in the fitted model (natural log of their odds ratios
rounded to the nearest decimal) (Appendix). The sum of this
numerical score in an individual patient could then be used to predict
his or her in-hospital death. A risk prediction tool that plotted the
various score levels against the corresponding predicted death was
developed to aid clinicians in predicting in-hospital death for patients
with type A aortic dissection.

Clinical Events Results

Chart review was used to document in-hospital clinical events and
in-hospital death. Standard American College of Cardiology/Amer-
ican Heart Association definitions were used to denote various
in-hospital complications.23 Abrupt-onset pain was defined as doc-
umentation in patients’ charts of sudden severe tearing pain in the
chest, neck, or back, with maximum intensity at onset and that
brought the patient to medical attention. An ECG was noted as
abnormal if it showed pathologic Q waves, ST-segment deviation,
T-wave inversions, left bundle-branch block, or left ventricular
hypertrophy.
Statistical Analysis
Summary statistics are presented as frequencies and percentages,
mean⫾SD, or as median and interquartile ranges. In all cases,
missing data were not defaulted to negative, and denominators
reflect only cases reported. Associations of death among nominal
variables were compared by means of ␹2 tests and 2-sided Fisher
exact tests. Continuous univariate predictors for death were tested by
means of t tests or Wilcoxon Mann-Whitney tests as appropriate.
Overall Characteristics of IRAD Patients
Of the total of 874 patients with aortic dissection (both type
A and B) in IRAD, 547 patients had type A aortic dissection
(62.5%) (Tables 1 through 3). Their mean age was 61.9⫾14.1
years, with a majority being men (65.5%). Two thirds of
patients presented initially to an outside hospital and were
transferred to an IRAD center for further treatment. Nearly
79.7% of patients underwent surgery for repair of aortic
dissection. The reason for medical treatment was not speci-
fied in 5% of patients by their caring physician, whereas the
remaining patients were treated medically for comorbid
conditions (55%), old age (17%, all but one patient ⬎70 years
of age; mean age, 79.9⫾5.8 years), refusal by the patient
(14%), having only intramural hematoma (7%), and extensive
dissection involving the descending aorta (17%). In-hospital
death occurred in one third of patients (32.5%) and was
 202 Circulation January 15, 2002

TABLE 2. Clinical Presentations, Signs, and Diagnostic Imaging Results of All Patients With
Type A Aortic Dissection
Variable Overall Survived Died P
Clinical presentations and signs
Abrupt onset of pain 435 (84.5) 289 (82.3) 146 (89.0) 0.05
Migrating pain 69 (13.6) 38 (11.1) 31 (18.8) 0.02
All neurological deficits 93 (17.0) 53 (14.4) 40 (22.5) 0.02
Coma/altered consciousness 78 (15.0) 33 (9.5) 45 (26.5) ⬍0.0001
Syncope 96 (18.5) 63 (17.9) 33 (19.8) 0.60
Congestive heart failure 31 (6.1) 26 (7.5) 5 (3.0) 0.05
Mean systolic blood pressure (SD), mm Hg 127 (39.8) 133 (35.7) 115 (45.3) ⬍0.0001
Mean diastolic blood pressure (SD), mm Hg 72 (24.9) 75 (22.3) 66 (29.2) ⬍0.0001
Hypotension/shock/tamponade 154 (29.0) 72 (20.1) 82 (47.1) ⬍0.0001
Any pulse deficit 153 (30.1) 84 (24.7) 69 (41.1) 0.0002
Diagnostic imaging
Chest radiography 475 (86.8) 323 (87.5) 152 (85.4) 0.49
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Normal 64 (13.4) 53 (16.4) 11 (7.2) 0.006

Widened mediastinum 295 (62.1) 188 (58.2) 107 (70.4) 0.01
ECG 514 (94.0) 353 (95.7) 161 (90.5) 0.02
Normal 156 (30.4) 123 (34.8) 33 (20.5) 0.001
New Q-wave or ST deviations 31 (6.2) 13 (3.8) 18 (11.5) 0.001
Diagnostic imaging findings
Arch involvement 121 (27.3) 87 (28.8) 34 (23.9) 0.28
Intramural hematoma 25 (8.1) 16 (4.8) 9 (5.6) 0.70
Periaortic hematoma 123 (25.6) 75 (23.1) 48 (30.8) 0.07
False lumen thrombosis 35 (8.4) 28 (10.3) 7 (5.7) 0.14
Aortic regurgitation 298 (59.5) 210 (61.8) 88 (54.7) 0.13
Coronary artery compromise 61 (14.8) 44 (15.4) 17 (13.4) 0.59
Pericardial effusion 229 (45.1) 146 (42.3) 83 (50.9) 0.07
Values are n (%) unless otherwise indicated.

26.9% in surgically treated patients versus 56.2% in those
treated medically without surgery. The cause of death was not
specified in 33.3% of these patients, whereas rupture ac-
counted for a third of death (33.3%), followed by neurolog-
ical deficit (13.9%), visceral ischemia/kidney failure (11.5%)
and cardiac tamponade (7.9%) in the remaining.
Univariate Predictors of In-Hospital Death for All
Patients With Type A Aortic Dissection
Clinical characteristics that showed significant association
included advanced age, female sex, abrupt onset and migra-
tory chest pain, hypotension/shock/tamponade on presenta-
tion, and evidence of neurological or pulse deficits at presen-
tation (Tables 1 through 3). Furthermore, the presence of a
widened mediastinum on chest radiography, electrocardio-
graphic evidence of new Q waves and/or ST-segment devia-
tions, or a lack of a normal ECG were associated with higher
in-hospital mortality rates. As expected, complications such
as neurological deficit, myocardial ischemia, hypotension,
kidney failure, and limb ischemia were also more frequent in
patients who died than in those who survived. On the other
hand, a medical history of hypertension, diabetes, aneurysm,
or heart surgery was similar in the two groups of patients.
Predictive Model for In-Hospital Death
Independent predictors of in-hospital death are as shown in
Table 4. The area under the receiver operating curve for the
model was 0.74, suggesting good model discrimination. The
deviance probability value was 0.12, and the Hosmer-
Lemeshow statistic was not significant, indicating little de-
parture from a perfect fit (␹2⫽4.3; df⫽7; P⫽0.75). Figure 1
plots expected deaths versus observed deaths over the risk
categories.
Variables Score and the Bedside Risk
Prediction Tool
The risk variables and their allocated scores are listed in
Table 4. Kidney failure was given the highest score (1.6),
whereas sex was given the lowest score (0.3), with other
variable scores being in between these values [hypoten-
sion/shock/tamponade (1.1), abrupt onset of pain (1.0), age
ⱖ70 (0.5), and abnormal ECG on presentation (0.6)].
There was a good agreement between observed and pre-
dicted death over score categories (Figure 2.). The simple
bedside risk prediction tool is shown in the Appendix and
in Table 4.
 Mehta et al Predicting Death in Type A Aortic Dissection 203

TABLE 3. In-Hospital Treatments and Complications in Patients With Type A

Aortic Dissection
Variable Overall Survived Died P
Definitive treatment
Surgery 436 (79.7) 320 (73.4) 116 (26.6) *⬍0.0001
Medical management 111 (20.3) 49 (44.1) 62 (55.9)
In-hospital complications
All neurological deficits 97 (17.8) 55 (14.9) 42 (23.9) 0.01
Coma/altered consciousness 80 (15.3) 34 (9.7) 46 (27.1) ⬍0.0001
Myocardial ischemia 57 (11.2) 33 (9.5) 24 (14.9) 0.07
Mesenteric ischemia 16 (3.2) 7 (2.0) 9 (5.6) 0.03
Acute kidney failure 28 (5.6) 10 (2.9) 18 (11.3) 0.0002
Hypotension 137 (27.0) 59 (17.0) 78 (48.8) ⬍0.0001
Cardiac tamponade 84 (16.5) 34 (9.9) 50 (31.1) ⬍0.0001
Limb ischemia 48 (9.5) 25 (7.3) 23 (14.5) 0.01
Values are n (%) unless otherwise indicated.
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*Probability value of the ␹2 test for surgical vs medical management.

Discussion Clinical Variables Associated With High In-Hospital

High In-Hospital Mortality Rates in Patients With
Type A Acute Aortic Dissection
The present study shows that in-hospital mortality rates in
patients with type A acute aortic dissection remain high, with
nearly 1 of 3 patients dying, even in centers that have
extensive expertise and interest in the treatment of these
high-risk patients. Furthermore, it identifies rupture of the
dissecting aorta to be the cause of death in roughly one third
of these patients. This high mortality rate in an era of
advanced surgical techniques and increasing expertise of
anesthesiologists, cardiologists, and cardiac and vascular
surgeons in treating this disorder may be a result of inclusion
in this study of all patients seen at these sites rather than
patients selected to undergo surgery. The inclusion of patients
who were too ill for surgery or died before they received
surgical repair may explain part of the increased mortality
rate. Also, the mean age of the patients in the present study
was higher than that in any of the prior investigations, and
because age is an important predictor of adverse outcomes,
this may also have contributed to higher mortality rate in our
study.
Mortality Rates and Their Implications
Our study identified several clinical variables to be important
predictors of death in patients with acute type A dissection
(Table 3) that are similar to those reported in prior studies
(Table 4).5,11–14,16,17,24 The similarities of variables predicting
in-hospital death in these prior reports and our study support
the clinical relevancy of the current predictive model. That
older age is associated with worse outcomes is not surprising
and is consistent with prior reports.11,13,14 Abrupt onset of
chest, neck, or back pain may be a manifestation of more
sudden, severe, and extensive tearing and thus may have
independently predicted greater risk of death in our study.
A common theme in prior publications as well as in our
study is that rupture and complications such as hypotension,
shock, cardiac tamponade, pulse deficits, and kidney failure
confer an even higher mortality rate. These findings may have
obvious therapeutic implications, which in turn may result in
a significant effect on the overall patient survival. Aggressive
surgical correction of the dissecting aneurysm may not only
help prevent rupture but also is the only option that will
provide a reasonable chance of survival to these individuals
with otherwise dismal outcome. Many complications in

TABLE 4. Prediction Models

Overall %
Type Among % Among Parameter Score
Overall Model Variables A, % Survivors Deaths Coefficient Assigned P Death, OR (95% CI)
Age ⱖ70 y 35.2 30.0 46.1 0.53 0.5 0.03 1.70 (1.05–2.77)
Female 34.5 30.7 42.7 0.32 0.3 0.20 1.38 (0.85–2.27)
Abrupt onset pain* 84.5 82.3 89.0 0.96 1.0 0.01 2.60 (1.22, 5.54)
Abnormal ECG* 69.6 65.2 79.5 0.57 0.6 0.03 1.77 (1.06, 2.95)
Any pulse deficit* 30.1 24.7 41.1 0.71 0.7 0.004 2.03 (1.25, 3.29)
Kidney failure† 5.6 2.9 11.9 1.56 1.6 0.002 4.77 (1.80, 12.6)
Hypotension/shock/tamponade* 29.0 20.1 47.1 1.09 1.1 ⬍0.0001 2.97 (1.83, 4.81)
*On presentation; †on presentation and before surgery.
 204 Circulation January 15, 2002
Figure 1. Observed vs predicted death for acute type A aortic
dissection.
patients with acute aortic type A dissection may be similarly
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prevented by earlier and more aggressive surgical treatment.
If complications have already developed, attempts should be
made to try and minimize their deleterious effect by estab-
lishing effective visceral (renal, cerebral, mesenteric) blood
flow and relieving organ ischemia in a timely fashion either
through surgery or by percutaneous techniques such as
fenestration and/or endoluminal stents followed by definitive
surgical repair. This latter approach is less invasive and can
quickly restore vital organ perfusion so that the patient with
malperfusion can be stabilized and then go on to have a
successful repair. Preliminary results of this approach at our
institution as well as other sites have been encouraging.25–28
Risk Prediction Bedside Tool for Predicting Death
The present study incorporated variables at presentation that
were independently associated with death into a simple risk
prediction tool that is relatively accurate in predicting risk of
death in patients with acute type A aortic dissection (Table 4).
The model risk prediction estimates should help clinicians
while making recommendations about different treatment
options for individual patients with type A dissection. Like
risk prediction tools for other cardiovascular diseases, this
Figure 2. Observed vs predicted death for acute type A aortic
dissection based on risk score. Note that as the score
increases, the predicted and observed mortality rates increased.
tool should be used by physicians for counseling patients and
their families in helping them to understand their predicted
risk and to have realistic expectations in terms of outcomes,
especially in those deemed to be at high risk for in-hospital
death. Model predictions should not necessarily be used to
deny aggressive treatment in such patients who otherwise
have a dismal prognosis. Finally, the prediction tool should
be helpful in evaluating effects of new approaches and
diagnostic methods as IRAD goes forward.
Uniqueness of the Present Study
Important differences between our study and prior investiga-
tions need to be highlighted. Most prior studies included a
small number of patients from a single center with type A and
B acute or chronic aortic dissection, whereas our analysis was
performed on a large number of patients with only acute type
A dissection presenting to 18 different IRAD sites. Further-
more, unselected consecutive patients with type A aortic
dissection, irrespective of treatment strategies (surgical or
medical), were analyzed in contrast to most prior investiga-
tions, which evaluated only the surgical cohort (Table 5).
Thus, the findings of our study can be generalized to patients
with acute type A dissection having a broad spectrum of
clinical presentation across diverse medical institutions. Fi-
nally, this study provides an important risk prediction tool
that allows accurate estimation of a patient’s in-hospital risk
of death at the bedside through the use of readily available
clinical information at presentation. This tool could also be
valuable in outcome research to estimate risk-adjusted out-
comes while comparing different subgroups of patients with
type A dissection.
Limitations of Our Study
The results of our study should not be generalized to patients
with chronic stable type A dissection or to patients who are
selected to undergo surgery. We measured only one easily
and reliably measurable outcome domain, in-hospital death,
which, although important to patients, is not sufficient for the
full evaluation of patients with type A aortic dissection. Our
focus on death as the only outcome should not diminish the
importance of other outcome variables such as nonfatal
adverse events, patient functional status, patient satisfaction,
and resource use. Future studies are needed to address the
best approach for evaluating the predictors of these other
domains.
Conclusions
Our study supports prior observations that acute type A
dissection is associated with high morbidity and mortality
rates despite recent advances in treatment. This study further
indicates that multiple factors affect in-hospital death and
help to identify these predictors. In addition, it provides a
useful, simple, bedside risk prediction tool that could be used
by physicians not only for determining the prognosis of
patients and counseling them and their families regarding
their risks but also as a research tool to better understand the
impact of newer diagnostic and therapeutic technological
advances in the treatment of patients with acute type A aortic
dissection.
 Mehta et al Predicting Death in Type A Aortic Dissection 205

TABLE 5. Studies Predicting Death in Patients With Type A Aortic Dissection

All Patients or
Aneurysm or Type A Acute or Single-Center or Only Those
Study n Dissection or B Chronic Multicenter Treated Surgically Predictors of Death OR P
Goosen et al 5 148 Dissection A Both Single Surgical Preoperative resuscitation 72.7 0.001
Postoperative hemodialysis 7.6 0.004
Postoperative neurological deficit 5.8 0.004
Svensson et al 11 717 Both A Both Single Surgical Increased age 9.69 0.040
Severe aneurysm symptoms 䡠䡠䡠 0.026
Preoperative heart failure 7.44 0.007
Postoperative cardiac dysfunction 21.93 0.0003
Biglioli et al 12 158 Both Both Both Single Surgical Cardiopulmonary bypass time 1.01/min 0.0021
Emergency operation 2.27 0.0022
Arch replacement 2.71 0.0067
Femoral artery cannulation 1.89 0.0375
Ehrlich et al 13 109 Dissection A Acute Single Surgical Older age 1.64 ⬍0.05
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Lack of retrograde cardioplegia 3.62 ⬍0.05

Fann et al14 360 Dissection Both Both Single Surgical Earlier operative year NR NR
Hypertension NR NR
Cardiac tamponade NR NR
Renal dysfunction NR NR
Older age NR NR
Pansini et al16 291 Dissection A Acute Single Surgical Preoperative shock 1.6 0.001
Bleeding ⬎1000 mL/24 h 1.6 0.023
Preoperative neurological deficit 1.9 0.007
Operation before 1986 1.8 0.024
Clamping time ⬎70 min 1.5 0.035
Chirillo et al 17 290 Dissection Both Both Multicenter Surgical Acute myocardial infarction 1.56 0.0004
Neurological deficit 1.46 0.003
Shock 1.35 0.0003
Lytle et al24 225 Both A Both Single center Surgical CABG 10.3 0.0001
Emergency 7.0 0.0009
Surgical period 0.28 0.0221
Arch replacement 6.7 0.0275
NR indicates not reported.

Appendix 6. Nienaber CA, von Kodolitsch Y, Petersen B, et al. Intramural hemorrhage

Score⫽Age · 0.5331 ⫹ Sex · 0.3244 ⫹ Abrupt Onset Chest Pain at
Presentation · 0.9569 ⫹ Pulse Deficit at Presentation · 0.7089 ⫹
Abnormal ECG at Presentation · 0.5714 · Renal Failure at Presen-
tation or Before Surgery · 1.5616 ⫹ Hypotension/Shock/Tamponade
at Presentation · 1.0876, with Age an indicator for Age ⱖ70; Sex an
indicator with female⫽1, male⫽0; and the other variables being
indicators for respective conditions. Note logit (probability of in-
hospital death)⫽Score ⫹ (⫺2.94), where ⫺2.94 is the intercept.
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 Predicting Death in Patients With Acute Type A Aortic Dissection
Rajendra H. Mehta, Toru Suzuki, Peter G. Hagan, Eduardo Bossone, Dan Gilon, Alfredo Llovet,
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Nienaber and Kim A. Eagle
on Behalf of the International Registry of Acute Aortic Dissection (IRAD) Investigators
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Circulation. 2002;105:200-206
doi: 10.1161/hc0202.102246
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Copyright © 2002 American Heart Association, Inc. All rights reserved.
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