Risk Factors for Postoperative Mortality in Patients with Acute Stanford Type A Aortic Dissection.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2021-10-21 eCollection Date: 2021-01-01 DOI:10.2147/IJGM.S330325
Yan Huo, Hui Zhang, Bo Li, Kun Zhang, Bin Li, Shao-Han Guo, Zhen-Jie Hu, Gui-Jun Zhu
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引用次数: 4

Abstract

Objective: The present study explored the risk factors of postoperative mortality in patients with acute Stanford type A aortic dissection (AD).

Methods: The study included 149 patients with acute Stanford type A AD who were treated at the Fourth Hospital of Hebei Medical University, China, from October 2016 to October 2018. The patients were divided into a death (n = 42) and survival group (n = 107) according to individual prognosis. Univariate analysis of all possible related risk factors was conducted; multivariate logistic regression analysis of the potential risk factors that showed statistical differences in the univariate analysis was also performed.

Results: The results of the univariate analysis showed that a body mass index (BMI) ≥25 kg/m2, surgery duration, duration of cardiopulmonary bypass, duration of cardiopulmonary bypass assistance, total transfusion of red blood cells, postoperative APACHE II score, sequential organ failure assessment (SOFA) score, low cardiac output, acute kidney injury (AKI), hypoxemia, diffuse intravascular coagulation (DIC), hepatic failure and other related complications, as well as postoperative stay duration in the intensive care unit (ICU), were closely correlated with a poor prognosis among patients. Multivariate logistic regression analysis showed that a BMI ≥25 kg/m2, SOFA score >8, duration of cardiopulmonary bypass assistance >70 minutes, postoperative low cardiac output, and postoperative DIC were independent risk factors for postoperative death in patients with acute Stanford type A AD.

Conclusion: A BMI ≥25 kg/m2, SOFA score >8, duration of cardiopulmonary bypass assistance >70 min, postoperative DIC, and postoperative low cardiac output were the independent risk factors for postoperative death in acute Stanford type A AD. Intraoperative blood transfusion, postoperative hepatic failure, and AKI, among others, correlated with an increased risk of death but were not independent risk factors for death.

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急性Stanford A型主动脉夹层患者术后死亡率的危险因素
目的:探讨急性斯坦福A型主动脉夹层(AD)患者术后死亡的危险因素。方法:本研究纳入了2016年10月至2018年10月在中国河北医科大学第四医院接受治疗的149名急性斯坦福A型AD患者。根据个体预后将患者分为死亡组(n=42)和存活组(n=107)。对所有可能的相关风险因素进行了单变量分析;还对潜在危险因素进行了多变量logistic回归分析,这些因素在单变量分析中显示出统计学差异。结果:单因素分析结果显示,体重指数(BMI)≥25kg/m2、手术持续时间、体外循环持续时间、心肺转流辅助持续时间、红细胞输注总量、术后APACHE II评分、连续器官衰竭评估(SOFA)评分、低心输出量、急性肾损伤(AKI)、低氧血症,弥漫性血管内凝血(DIC)、肝衰竭和其他相关并发症,以及术后在重症监护室(ICU)的住院时间,与患者的不良预后密切相关。多因素logistic回归分析显示,BMI≥25kg/m2、SOFA评分>8、体外循环辅助时间>70min、术后低心输出量和术后DIC是急性Stanford a型AD患者术后死亡的独立危险因素,术后DIC和术后低心输出量是急性Stanford A型AD术后死亡的独立危险因素。术中输血、术后肝衰竭和AKI等与死亡风险增加相关,但不是死亡的独立风险因素。
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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
期刊介绍: ACS Applied Bio Materials is an interdisciplinary journal publishing original research covering all aspects of biomaterials and biointerfaces including and beyond the traditional biosensing, biomedical and therapeutic applications. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrates knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important bio applications. The journal is specifically interested in work that addresses the relationship between structure and function and assesses the stability and degradation of materials under relevant environmental and biological conditions.
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