CTA-based morphological parameters predict adverse prognosis in stanford type B aortic dissection: a single-center retrospective cohort study.
- 1Department of Radiology, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China.
Abstract
Objective
To investigate the prognostic value of computed tomography angiography (CTA)-based morphological parameters for adverse aortic events in patients with acute Stanford type B aortic dissection (TBAD) and to develop an internally validated prediction model.Methods
This single-center retrospective cohort study included 292 consecutive patients with CTA-confirmed acute TBAD. Baseline clinical and CTA-derived morphological variables were collected, and the primary endpoint was a composite of adverse aortic events. Candidate predictors were evaluated using least absolute shrinkage and selection operator (LASSO) logistic regression with 10-fold cross-validation, followed by multivariable logistic regression. Model performance was assessed using discrimination, calibration, precision-recall analysis, and decision curve analysis, with internal validation based on 1,000 bootstrap resamples.Results
During a median follow-up of 13.20 months (interquartile range, 8.15-19.52 months), 78 patients (26.7%) experienced adverse aortic events. The final LASSO-selected model included age, symptom onset-to-admission time, white blood cell count, D-dimer, maximum aortic diameter, TL/FL ratio, and false lumen status. In multivariable analysis, older age (adjusted OR = 1.043), higher white blood cell count (OR = 1.164), higher D-dimer (OR = 1.056), and larger maximum aortic diameter (OR = 1.110) were associated with higher odds of adverse events, whereas a higher TL/FL ratio was inversely associated with the outcome (OR = 0.060). Compared with partial false-lumen thrombosis, patent false lumen was associated with higher odds (OR = 3.718), whereas complete thrombosis was associated with lower odds (OR = 0.253). The apparent AUC was 0.849 (95% CI: 0.800-0.898), and the optimism-corrected AUC was 0.828 after 1,000 bootstrap resamples. The optimism-corrected calibration slope and Brier score were 0.893 and 0.143, respectively. The AUPRC was 0.708 vs. a no-skill baseline of 0.267, and decision curve analysis showed positive net benefit across a broad range of threshold probabilities.Conclusion
A model integrating baseline clinical and CTA-derived morphological characteristics demonstrated good internally validated discrimination and reasonable calibration for short- to medium-term adverse aortic events in acute TBAD. Independent external validation is required before broader clinical application.
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BibTeX
@article{pan2026ctabased,
title = {{CTA-based morphological parameters predict adverse prognosis in stanford type B aortic dissection: a single-center retrospective cohort study.}},
author = {Xiaolong Pan and Mengli Wang and Yang Sun and Tingting Zhang},
journal = {Frontiers in cardiovascular medicine},
year = {2026},
month = oct,
doi = {10.3389/fcvm.2026.1892266},
url = {https://europepmc.org/article/MED/42908986},
note = {CC BY},
}
RIS
TY - JOUR
TI - CTA-based morphological parameters predict adverse prognosis in stanford type B aortic dissection: a single-center retrospective cohort study.
AU - Xiaolong Pan
AU - Mengli Wang
AU - Yang Sun
AU - Tingting Zhang
PY - 2026
DA - 2026/10/07
JO - Frontiers in cardiovascular medicine
DO - 10.3389/fcvm.2026.1892266
UR - https://europepmc.org/article/MED/42908986
AB - Objective To investigate the prognostic value of computed tomography angiography (CTA)-based morphological parameters for adverse aortic events in patients with acute Stanford type B aortic dissection (TBAD) and to develop an internally validated prediction model.Methods This single-center retrospective cohort study included 292 consecutive patients with CTA-confirmed acute TBAD. Baseline clinical and CTA-derived morphological variables were collected, and the primary endpoint was a composite of adverse aortic events. Candidate predictors were evaluated using least absolute shrinkage and selection operator (LASSO) logistic regression with 10-fold cross-validation, followed by multivariable logistic regression. Model performance was assessed using discrimination, calibration, precision-recall analysis, and decision curve analysis, with internal validation based on 1,000 bootstrap resamples.Results During a median follow-up of 13.20 months (interquartile range, 8.15-19.52 months), 78 patients (26.7%) experienced adverse aortic events. The final LASSO-selected model included age, symptom onset-to-admission time, white blood cell count, D-dimer, maximum aortic diameter, TL/FL ratio, and false lumen status. In multivariable analysis, older age (adjusted OR = 1.043), higher white blood cell count (OR = 1.164), higher D-dimer (OR = 1.056), and larger maximum aortic diameter (OR = 1.110) were associated with higher odds of adverse events, whereas a higher TL/FL ratio was inversely associated with the outcome (OR = 0.060). Compared with partial false-lumen thrombosis, patent false lumen was associated with higher odds (OR = 3.718), whereas complete thrombosis was associated with lower odds (OR = 0.253). The apparent AUC was 0.849 (95% CI: 0.800-0.898), and the optimism-corrected AUC was 0.828 after 1,000 bootstrap resamples. The optimism-corrected calibration slope and Brier score were 0.893 and 0.143, respectively. The AUPRC was 0.708 vs. a no-skill baseline of 0.267, and decision curve analysis showed positive net benefit across a broad range of threshold probabilities.Conclusion A model integrating baseline clinical and CTA-derived morphological characteristics demonstrated good internally validated discrimination and reasonable calibration for short- to medium-term adverse aortic events in acute TBAD. Independent external validation is required before broader clinical application.
SN - 2297-055X
ER -