Predictive value of age,creatinine,and ejection fraction(ACEF) score for in-hospital mortality and major adverse events in patients with acute type A aortic dissection

Background Patients with decreased cardiac and renal function,as well as old age suffer from poor out-comes when undergoing cardiac surgery.The aim of this study was to evaluate the association of age,creatinine and ejection fraction (ACEF) score with in-hospital prognosis of patients with the acute type A aortic dissection(ATAAD).Methods From September 2017 to June 2021,a total of 435 ATAAD patients undergoing open sur-gery repair were enrolled,and classified into low ACEF (ACEF score ＜0.91,n=286) and high ACEF group(ACEF score ≥0.91,n=149) according to the optimal cutoff value of 0.91.Logistic regression analysis was per-formed to investigate the association between ACEF score with adverse events.Results Thirty-five (8.0％) pa-tients were excluded and 94 (21.6％) developed in-hospital major adverse clinical events (MACEs) during hospi-talization.The in-hospital mortality in high ACEF group was significantly higher than in low ACEF group(13.4％ vs.5.2％,P=0.003).The in-hospital MACE rate was also significantly higher in patients with high ACEF score (high ACEF group:27.5％ vs.low ACEF group:18.5％,P=0.031).Multivariable logistic analysis revealed that ACEF score was an independent indicator for in-hospital mortality[odds ratio (OR):5.66,95％ confidence in-terval (CI):1.43-22.48,P=0.014]and in-hospital MACEs (OR:3.44,95％ CI:1.30-9.15,P=0.013).Conclu-sions Elevated ACEF score was an independent predictor for in-hospital mortality and MACEs in patients with ATAAD undergoing open surgery repair,which might provide additional risk stratification.