Clinical Report: Creation and external validation of a nomogram for forecasting PMV

Overview

This study developed and validated a nomogram to predict prolonged mechanical ventilation (PMV) in patients undergoing surgery for acute type A aortic dissection (ATAAD). The model demonstrated good discriminatory ability and calibration.

Background

Prolonged mechanical ventilation (PMV) significantly impacts outcomes in patients undergoing surgery for acute type A aortic dissection (ATAAD). Accurate prediction of PMV can guide clinicians in tailoring perioperative management. This study addresses the need for a validated predictive tool that incorporates multiple risk factors.

Data Highlights

Key Findings

• The nomogram includes ten predictors for PMV risk after ATAAD surgery.
• Good discriminatory ability was demonstrated with AUC values of 0.796 in the training cohort and 0.765 in the validation cohort.
• Calibration was excellent, with Hosmer–Lemeshow test results indicating no significant deviation from perfect calibration.
• At optimal cutoff values, the nomogram achieved a sensitivity of 78.6% and specificity of 66.7% in the training cohort.

Clinical Implications

The nomogram can assist clinicians in identifying patients at high risk for prolonged mechanical ventilation after ATAAD surgery. This tool may facilitate timely interventions and improve perioperative management strategies.

Conclusion

The developed nomogram effectively predicts the risk of PMV in ATAAD surgery patients.

Related Resources & Content

1. American Association for Thoracic Surgery, AATS, 2025 -- Overview of contemporary guidelines for management of acute type A aortic dissection
2. Frontiers in Cardiovascular Medicine, 2025 -- Risk factors of prolonged mechanical ventilation after acute type A aortic dissection surgery: a single-center retrospective study
3. European Radiology — Utilizing Deep Learning to Assess False-Lumen Volumes for Improved Prediction of Adverse Remodeling in Patients with Residual Aortic Dissection on CT
4. Clinical Research in Cardiology — Prognostic Significance and Diagnostic Utility of Invasively Obtained Hemodynamic Metrics in Severe Aortic Stenosis Patients Undergoing Transcatheter Aortic Valve Implantation
5. Frontiers in Medicine — Predictive Value of Initial Triage Vital Signs for In-Hospital Mortality in Acute Aortic Dissection Patients: A Retrospective Study in the Emergency Department
6. Frontiers in Pediatrics — Development and validation of a clinical nomogram for predicting 30-day in-hospital mortality in children with moderate-to-severe traumatic brain injury
7. Overview of… | The American Association for Thoracic Surgery | AATS
8. Frontiers | Risk factors of prolonged mechanical ventilation after acute type A aortic dissection surgery: a single-center retrospective study
9. Intraoperative Factors Associated With Mechanical Ventilation Duration Following Aortic Surgery - ScienceDirect