Prognostic Value Of APACHE ? Score In Predicting In-hospital Mortality For Patients With Type A Acute Aortic Dissection

Objective:To investigate the predictive value of level of acute physiology and chronic health evaluation ?(APACHE ?)scoring system for in-hospital in patients with type A acute aortic dissection(AAD).Methods:Clinical date of 139 patients treated type A acute aortic dissection from January 2013 to December 2016 was collected in the First Affiliated Hospital of Xinjiang Medical University.Total of 139 enrolled patients Was divided into the survival group and non-survival group according to in-hospital death.The prognosis of type A AAD.All the patients were divided into the APACHE ??8.5 min and the APACHE ?<8.5 min.Univariate and multivariate Cox regression analysis was used to evaluate the relevant indexes.Results:Compared with the difference between the death group and the survival group,.the APACHE ? score[(13.22±4.00)min vs(10.07±4.04)min,P=0.00],systolicblood pressure(SBP)[(141.16±28.53)mmHg vs(129.61±26.91)mm Hg,P=0.040],and White blood count(WBC)[(14.86±5.28)×10~9/L vs(12.35±4.27)×10~9/L,P=0.02],Platelet count(PLT)[(154.33±48.94)×10~9/L vs(186.20±67.91)×10~9/L,P=0.01],hospital day[(3.39±5.74)d vs(19.87±14.24)d,P=0.00]was significant different between death group and survival group.Multivariate Cox regression analysis indicated that APACHE ??8.5 min had high risk of in-hospital death.With adjusted age,SBP,WBC,PLT,APACHE ??8.5 min were independent predictive factors of in-hospital mortality[hazard ratio(HR)2.16,95%confidence interval(CI)1.02~4.57,P=0.04],when surgery is added to multivariate Cox regression analysis,APACHE ??11.5 min is no longer related to in-hospital mortality(HR:1.08,95%CI:0.50~2.32,P=0.85),while SBP and WBC were independent predictive factors of in-hospital mortality.Respectively,the HR were 0.99(95%CI:0.97~0.10,P=0.03)and1.12(95%CI:1.05~1.19,P=0.00).Conclusion:For patients with type AAAD,the higher APACHE ? score,the higher risk of in-hospital death,and white blood cell can also serve as a reference marker for assessing the risk of hospital death.