Nomogram to Predict Delayed Complications in Patients with Uncomplicated Acute Type B Aortic Dissection

Background: Delayed complications within the first 2 weeks in initially uncomplicated acute type B aortic dissection (uATBAD) are not scarce, which needs special attention to prevent potentially fatal complications. This study aims to develop a nomogram for estimating the probability of patients with uATBAD developing delayed complications. Methods The nomogram was derived from a retrospectively study of 135 patients with uATBAD from 2011 to 2021 at a single medical center. The performance of the nomogram was evaluated from discrimination, calibration, and clinical usefulness. The results were internally validated by bootstrapping. Results In the multivariate analysis, the independent predictors of delayed complications identified were age ≥65 years (OR, 0.320; 95%CI, 0.108-0.831; P = 0.027), C-reactive protein (OR, 1.017; 95%CI, 1.006-1.029; P = 0.003), and maximum diameter of primary entry tear (OR, 1.089; 95%CI, 1.025-1.162; P = 0.007). The prediction model was internally validated by bootstrapping and revealed good discrimination (optimism-corrected C statistic, 0.706) and good calibration (Hosmer–Lemeshow test, P = 0.6468). Decision curve analysis demonstrated that the prediction nomogram was clinically useful. Conclusions This study presents a nomogram based on independent predictors of clinical and morphological parameters that could help identify patients with uATBAD who might occur delayed complications and thus improve the prognosis of patients.