{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T13:24:10Z","timestamp":1771075450974,"version":"3.50.1"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>We aimed to assess the long-term survival following surgical repair because of acute type A aortic dissection (ATAAD) and the correlation with the preoperative GERAADA (German Registry for Acute Type A Aortic Dissection)-score value.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We enrolled patients who underwent emergent aortic surgery because of ATAAD from 2010 to 2022 from 9 hospitals. Follow-up information was obtained by matching the clinical patient data with a national administrative database. Discrimination and calibration of GERAADA were tested at 1, 2, 5, and 10 years. The relationship between long-term outcome and score was also tested through time-to-event methods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 1110 patients were analysed: Median age was 67 years [IQR 57-75], and 30.8% of subjects were female. Median GERAADA score was 14.3% [10.2-22]. Mean length of follow-up was 4.19 years. The Kaplan-Meier estimates of survival at 5 and 10 years were, respectively, 62.5% \u00b1 1.5%, and 48.5% \u00b1 2.1%. Discrimination was poor but remained stable over the time (area under the curve [AUC] at 1-year follow-up: 0.66; 95% CI 0.63-0.70. AUC at 10-year follow-up: 0.64; 95% CI 0.61-0.68). Calibration plots showed underprediction until 50%-predicted probability and progressive overprediction afterward. There is a steep mortality in the first couple of months after surgery while afterward the mortality rate is constantly lower. GERAADA score was found to be a predictor of long-term mortality with a nonlinear association.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>GERAADA score showed a poor performance in predicting long-term survival.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivaf160","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T17:36:47Z","timestamp":1757525807000},"source":"Crossref","is-referenced-by-count":1,"title":["Utility of GERAADA Score for Predicting Long-term Survival Following Surgical Repair of Aortic Dissection"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1729-532X","authenticated-orcid":false,"given":"Francesco","family":"Pollari","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Klinikum N\u00fcrnberg\u2014Paracelsus Medical University , Nuremberg, 90471,","place":["Germany"]},{"name":"Universit\u00e0 degli Studi di Milano , Milan, 20122,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Nardi","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Tor Vergata Policlinic University, Tor Vergata University of Rome , Rome, 00133,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Mikus","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Maria Cecilia Hospital, GVM Care & Research , Cotignola, 48033,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Ferraro","sequence":"additional","affiliation":[{"name":"Cardiovascular Sciences Department, Agostino Gemelli Foundation Polyclinic IRCCS, Catholic University of the Sacred Heart , Rome, 00168,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Gemelli","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova , Padua, 35128,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2676-0457","authenticated-orcid":false,"given":"Ilaria","family":"Franzese","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina , Trieste, 34128,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1354-9599","authenticated-orcid":false,"given":"Ilaria","family":"Chirichilli","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Heart Transplantation, San Camillo Forlanini Hospital , Rome, 00152,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Romagnoni","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Fondazione IRCCS Ca\u2019 Granda, Ospedale Maggiore Policlinico , Milan, 20122,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4913-9834","authenticated-orcid":false,"given":"Giuseppe","family":"Santarpino","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Citt\u00e0 di Lecce Hospital, GVM Care & Research , Lecce, 73100,","place":["Italy"]},{"name":"Cardiac Surgery, Department of Experimental and Clinical Science, Magna Graecia University of Catanzaro , Catanzaro, 88100,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Nicolardi","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, \u201cVito Fazzi\u201d Hospital , Lecce, 73100,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Scrofani","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Fondazione IRCCS Ca\u2019 Granda, Ospedale Maggiore Policlinico , Milan, 20122,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Ranocchi","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Heart Transplantation, San Camillo Forlanini Hospital , Rome, 00152,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enzo","family":"Mazzaro","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina , Trieste, 34128,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6261-699X","authenticated-orcid":false,"given":"Gino","family":"Gerosa","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova , Padua, 35128,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Massetti","sequence":"additional","affiliation":[{"name":"Cardiovascular Sciences Department, Agostino Gemelli Foundation Polyclinic IRCCS, Catholic University of the Sacred Heart , Rome, 00168,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Savini","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Maria Cecilia Hospital, GVM Care & Research , Cotignola, 48033,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Ruvolo","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, Tor Vergata Policlinic University, Tor Vergata University of Rome , Rome, 00133,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Di Marco","sequence":"additional","affiliation":[{"name":"Cardiac Surgery, IRCCS, Azienda Ospedaliero Universitaria di Bologna , Bologna, 40138,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oriana","family":"D'Ecclesiis","sequence":"additional","affiliation":[{"name":"Italian National Agency for Regional Healthcare Services (AGENAS) , Rome, 00187,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Guagneli","sequence":"additional","affiliation":[{"name":"Italian National Agency for Regional Healthcare Services (AGENAS) , Rome, 00187,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9436-630X","authenticated-orcid":false,"given":"Giorgia","family":"Duranti","sequence":"additional","affiliation":[{"name":"Italian National Agency for Regional Healthcare Services (AGENAS) , Rome, 00187,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Parolari","sequence":"additional","affiliation":[{"name":"University Unit of Cardiac Surgery, IRCCS Policlinico S. Donato , S. Donato Milanese, 20097,","place":["Italy"]},{"name":"Department of Biomedical Sciences, University of Milano , Milan, 20133,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Barili","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, Universit\u00e1 degli Studi di Milano , Milan, 20133,","place":["Italy"]},{"name":"University Cardiac Surgery Unit, IRCCS Ospedale Galeazzi Sant\u2019Ambrogio , Milan, 20157,","place":["Italy"]},{"name":"Harvard TH Chan School of Public Health , Boston, MA, 02115,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"GIROC (Italian Research Group on Outcome in Cardiac Surgery)","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Pollari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Di Marco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilaria","family":"Franzese","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cinzia","family":"Trumello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Nicol\u00f2","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandro","family":"Sponga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michela","family":"Cuomo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Salsano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Lechiancole","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Russo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Rosato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Moscarelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Santarpino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Nenna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,9,10]]},"reference":[{"key":"2025091919545807300_ivaf160-B1","doi-asserted-by":"publisher","first-page":"ezad426","DOI":"10.1093\/ejcts\/ezad426","article-title":"EACTS\/STS Guidelines for diagnosing and treating acute and chronic syndromes of the aortic organ","volume":"65","author":"Czerny","year":"2024","journal-title":"Eur J Cardiothorac Surg"},{"key":"2025091919545807300_ivaf160-B2","doi-asserted-by":"publisher","first-page":"ezae005","DOI":"10.1093\/ejcts\/ezae005","article-title":"Comparison of 4 mortality scores for surgical repair of type A aortic dissection: a multicentre external validation","volume":"65","author":"Pollari","year":"2024","journal-title":"Eur J Cardiothorac Surg"},{"key":"2025091919545807300_ivaf160-B3","year":"2024"},{"key":"2025091919545807300_ivaf160-B4","first-page":"569","article-title":"Comparison between administrative and clinical databases in the evaluation of cardiac surgery performance","volume":"9","author":"Rosato","year":"2008","journal-title":"G Ital Cardiol (Rome)"},{"key":"2025091919545807300_ivaf160-B5","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-4757-3462-1","volume-title":"Regression Modelling Strategies","author":"Harrell","year":"2001"},{"key":"2025091919545807300_ivaf160-B6","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1016\/j.athoracsur.2016.04.017","article-title":"The impact of EuroSCORE II risk factors on prediction of long-term mortality","volume":"102","author":"Barili","year":"2016","journal-title":"Ann Thorac Surg"},{"key":"2025091919545807300_ivaf160-B7","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1093\/ejcts\/ezab168","article-title":"About usefulness of GERAADA score","volume":"60","author":"Pollari","year":"2021","journal-title":"Eur J Cardiothorac Surg"},{"key":"2025091919545807300_ivaf160-B8","doi-asserted-by":"publisher","first-page":"1224","DOI":"10.1016\/j.athoracsur.2024.07.045","article-title":"Long-term outcomes of antegrade thoracic stent grafting during repair of acute DeBakey I dissection","volume":"118","author":"Mosbahi","year":"2024","journal-title":"Ann Thorac Surg"},{"key":"2025091919545807300_ivaf160-B9","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.jtcvs.2022.12.009","article-title":"Distal aortic progression following acute type A aortic dissection repair among patients with bicuspid and tricuspid aortic valves","volume":"168","author":"Titsworth","year":"2024","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025091919545807300_ivaf160-B10","doi-asserted-by":"publisher","first-page":"ezae242","DOI":"10.1093\/ejcts\/ezae242","article-title":"Role of gender in short- and long-term outcomes after surgery for type A aortic dissection: analysis of a multicentre European registry","volume":"66","author":"Onorati","year":"2024","journal-title":"Eur J Cardiothorac Surg"},{"key":"2025091919545807300_ivaf160-B11","doi-asserted-by":"crossref","first-page":"7275","DOI":"10.1007\/s00330-024-10747-y","article-title":"Impact of pulmonary artery intramural hematoma on patients with acute type A aortic dissection","volume":"34","author":"Lv","year":"2024","journal-title":"Eur Radiol"},{"key":"2025091919545807300_ivaf160-B12","doi-asserted-by":"publisher","first-page":"ezad437","DOI":"10.1093\/ejcts\/ezad437","article-title":"Neurological prognosis in surgically treated acute aortic dissection with brain computed tomography perfusion","volume":"65","author":"Zhao","year":"2024","journal-title":"Eur J Cardiothorac Surg"},{"key":"2025091919545807300_ivaf160-B13","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1016\/j.athoracsur.2020.07.019","article-title":"Acute kidney injury after acute repair of type A aortic dissection","volume":"111","author":"Helgason","year":"2021","journal-title":"Ann Thorac Surg"},{"key":"2025091919545807300_ivaf160-B14","doi-asserted-by":"publisher","first-page":"e27","DOI":"10.1016\/j.jacc.2010.02.015","article-title":"American College of Cardiology Foundation\/American Heart Association Task Force on Practice Guidelines; American Association for Thoracic Surgery; American College of Radiology; American Stroke Association; Society of Cardiovascular Anesthesiologists; Society for Cardiovascular Angiography and Interventions; Society of Interventional Radiology; Society of Thoracic Surgeons; Society for Vascular Medicine. 2010 ACCF\/AHA\/AATS\/ACR\/ASA\/SCA\/SCAI\/SIR\/STS\/SVM Guidelines for the diagnosis and management of patients with thoracic aortic disease. A Report of the American College of Cardiology Foundation\/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine","volume":"55","author":"Hiratzka","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"2025091919545807300_ivaf160-B15","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1016\/j.jacc.2021.08.058","article-title":"Surveillance imaging following acute type A aortic dissection","volume":"78","author":"An","year":"2021","journal-title":"J Am Coll Cardiol"}],"container-title":["Interdisciplinary CardioVascular and Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/icvts\/advance-article-pdf\/doi\/10.1093\/icvts\/ivaf160\/64237297\/ivaf160.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/40\/9\/ivaf160\/64237297\/ivaf160.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/40\/9\/ivaf160\/64237297\/ivaf160.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T23:55:05Z","timestamp":1758326105000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/icvts\/article\/doi\/10.1093\/icvts\/ivaf160\/8250723"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":15,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9,2]]}},"URL":"https:\/\/doi.org\/10.1093\/icvts\/ivaf160","relation":{},"ISSN":["2753-670X"],"issn-type":[{"value":"2753-670X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,9]]},"published":{"date-parts":[[2025,9]]},"article-number":"ivaf160"}}