Abstract: Objective To analyze the effects of different preoperative model for end-stage liver disease(MELD)scores on the early death and postoperative complications in patients with acute Stanford type A aortic dissection(ATAAD)undergoing surgical treatment, and to explore the risk factors of early postoperative death. Methods The clinical data of 304 ATAAD patients who received surgery during Jan. 2018 and Dec. 2021 were retrospectively analyzed. According to the preoperative MELD score, the patients were divided into three groups: low MELD group(n=204, MELD <10), medium MELD group(n=72, 10≤MELD<15)and high MELD group(n=28, MELD≥15). The general data and perioperative clinical data were compared among the groups. Effects of preoperative MELD scores and other factors on the survival were determined with Cox regression analysis. Results Of the 304 patients enrolled, 63(20.7%)died in the early postoperative period. Patients with higher preoperative MELD score had significantly higher rate of mortality(P<0.001)and major adverse clinical events(MACEs)(P=0.007). Multivariate Cox regression showed that preoperative MELD ≥15 was independently associated with in-hospital mortality. Conclusion Increased preoperative MELD score and decreased liver function significantly increase early postoperative mortality and MACEs in patients with ATAAD. Preoperative MELD score is helpful for risk stratification of patients, and early prevention and intervention of high-risk patients can help improve the prognosis.

Key words: Model for end-stage liver disease, Liver function, Acute Stanford type A aortic dissection, Postoperative outcome, Risk factors