{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T01:24:57Z","timestamp":1766712297838,"version":"build-2065373602"},"reference-count":78,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stanford Type A aortic dissection (TAAD) is a life-threatening condition involving the ascending aorta and requires urgent surgery. This study developed 11 machine learning regression models to predict operative duration and identify key clinical factors influencing surgical time in TAAD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      In this single-center retrospective cohort study of 505 patients who underwent surgery from December 2017 to March 2023. Specifically, 11 machine learning models were construct using 47 preoperative and intraoperative features to predict operative duration. Model performance was assessed by R\n                      <jats:sup>2<\/jats:sup>\n                      , RMSE, and MAE, and SHAP analysis enhanced interpretability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study primarily consisted of middle-aged patients, comprising 73.4% males and 26.6% females. Furthermore, most patients underwent complex aortic procedures under time-constrained preoperative conditions. Procedures involving root replacement and total arch replacement were associated with longer surgical durations. The ExtraTrees Regressor had the highest predictive accuracy. SHAP analysis revealed five key features: Duration of extracorporeal circulation, Duration of aortic occlusion, Intraoperative blood transfusion, Treatment method for the aortic arch, and Treatment method for the aortic root.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study developed high-performance predictive models to identify key features affecting operative duration in TAAD surgery. Complex reconstructions prolong procedures, and longer aortic occlusion further contributes to this effect. The findings highlight the major influence of surgical strategies and intraoperative management on surgical duration. Special consideration remains warranted for specific patient subgroups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1682339","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T06:25:57Z","timestamp":1761891957000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Machine learning-based analysis of factors influencing surgical duration in type A aortic dissection"],"prefix":"10.3389","volume":"13","author":[{"given":"Dechao","family":"Deng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoming","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiangzhen","family":"Feng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaoli","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pingping","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinyu","family":"Cong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiang","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunmeng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benzheng","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/nrdp.2016.53","article-title":"Aortic dissection","volume":"2","author":"Nienaber","year":"2016","journal-title":"Nat Rev Dis Prim"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1016\/j.jvs.2021.08.080","article-title":"A systematic review and meta-analysis of the incidence of acute aortic dissections in population-based studies","volume":"75","author":"e Melo","year":"2022","journal-title":"J Vasc Surg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"100280","DOI":"10.1016\/j.lanwpc.2021.100280","article-title":"Incidence and survival of aortic dissection in urban China: results from the national insurance claims for epidemiological research (NICER) study","volume":"17","author":"Tang","year":"2021","journal-title":"Lancet Regional Health"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"890567","DOI":"10.3389\/fmed.2022.890567","article-title":"Simple death risk models to predict in-hospital outcomes in acute aortic dissection in emergency department","volume":"9","author":"Xing","year":"2022","journal-title":"Front Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.1016\/j.athoracsur.2023.06.019","article-title":"Characteristics and outcomes in patients with acute aortic dissection: a nationwide registry study","volume":"116","author":"Pedersen","year":"2023","journal-title":"Ann Thorac Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"I-350","DOI":"10.1161\/circulationaha.105.000497","article-title":"Long-term survival in patients presenting with type a acute aortic dissection","volume":"114","author":"Tsai","year":"2006","journal-title":"Circulation"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1703","DOI":"10.1016\/j.jacc.2020.07.061","article-title":"Type a aortic dissection\u2014experience over 5 decades: JACC historical breakthroughs in perspective","volume":"76","author":"Zhu","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1321700","DOI":"10.3389\/fcvm.2023.1321700","article-title":"Aortic arch branch-prioritized reconstruction for type a aortic dissection surgery","volume":"10","author":"Gao","year":"2024","journal-title":"Front. 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