Introduction
Acute type A aortic dissection (ATAAD) is a cardiovascular disease that requires urgent care. Emergency surgery is currently the primary treatment option for patients with ATAAD. Despite continual improvements in surgical techniques and perioperative management strategies, postoperative complications including paraplegia, stroke, acute kidney injury, low cardiac output syndrome, and acute lung injury (ALI) are common.1 In particular, the incidence of postoperative ALI after ATAAD is 30–50%.2Perioperative ALI significantly increases postoperative mortality, mechanical ventilation duration, intensive care unit (ICU) stay duration, and hospitalization cost in patients who undergo ATAAD repair, and outcomes are poor.3 Currently, variables included in the commonly used ALI score scales including LIPS and Murray are insufficient for predicting ALI occurrence after ATAAD. In addition, due to the lack of effective treatments for severe ALI, early identification of patients at high risk of developing ALI after ATAAD is highly important because it facilitates early intervention, and this prevents the progression to severe ALI. This study aimed to analyze risk factors of severe ALI after ATAAD and establish a prediction model that facilitates the identification of high-risk patients in order to allow physicians to make timely medical decisions.