A Multivariate Analysis of Perioperative Risk Factors on the 10 Year Survival of Patients with Acute Type A Aortic Dissection

Abstract Objective The goal of this study was to analyze perioperative risk factors to predict one- year mortality after operation for acute type A aortic dissection (AAD). Methods A total of 121 consecutive patients undergoing Stanford type A AAD surgery in Beijing Anzhen Hospital were enrolled. Preoperative clinical and laboratory data from patients were collected. Results Multivariable Cox regression analysis showed that significant factors associated with increased one-year mortality were elder age (year) (hazard ratio (HR) 1.0985; 95% confidence interval (CI) 1.0334–1.1677), intraoperative blood transfusion ≥2000 mL (HR 8.8081; 95% CI 2.3319–33.2709), a higher level of serum creatinine (μmol/L) at postoperative one day (HR 1.0122; 95% CI 1.0035–1.0190) and oxygenation index (OI) < 200 (mmHg) at the end of surgery (HR 5.7575; 95% CI 1.1695–28.3458). Conclusion In this study, perioperative risk factors to predict one-year prognosis are age, intraoperative blood transfusion ≥2000 mL, postoperative OI < 200 mmHg and level of postoperative serum creatinine. The results aid in the comprehension of surgical outcomes and assist in the optimization of treatment strategies for those with perioperative risk factors to decrease one-year mortality.

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Perioperative risk factors for delayed extubation after acute type A aortic dissection surgery

Journal of Thoracic Disease ◽

10.21037/jtd-20-742 ◽

2020 ◽

Vol 12 (9) ◽

pp. 4796-4804

Author(s):

Wiriya Maisat ◽

Sasiya Siriratwarangkul ◽

Apiporn Charoensri ◽

Wanchai Wongkornrat ◽

Saowaphak Lapmahapaisan

Keyword(s):

Risk Factors ◽

Aortic Dissection ◽

Type A ◽

Perioperative Risk ◽

Acute Type ◽

Type A Aortic Dissection ◽

Perioperative Risk Factors ◽

Delayed Extubation

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Trends and Risk Factors for Stroke and Mortality following Surgical Repair of acute Type A Aortic Dissection: A Single-Center Experience Over 15 Years

10.1055/s-0040-1705513 ◽

2020 ◽

Author(s):

F. Pollari ◽

S. Pfeiffer ◽

C. Eckrich ◽

J. Sirch ◽

T. Fischlein

Keyword(s):

Risk Factors ◽

Aortic Dissection ◽

Surgical Repair ◽

Type A ◽

Acute Type ◽

Single Center ◽

Type A Aortic Dissection ◽

Single Center Experience

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Risk factors for hypoxemia following surgical repair of acute type A aortic dissection

Interactive Cardiovascular and Thoracic Surgery ◽

10.1093/icvts/ivw272 ◽

2016 ◽

pp. ivw272

Author(s):

Nan Liu ◽

Wei Zhang ◽

Weiguo Ma ◽

Wei Shang ◽

Jun Zheng ◽

...

Keyword(s):

Risk Factors ◽

Aortic Dissection ◽

Surgical Repair ◽

Type A ◽

Acute Type ◽

Type A Aortic Dissection

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Preoperative hematological parameters are inadequate for predicting mortality in Stanford Type A aortic dissection repair

Clinical surgery research communications ◽

10.31491/csrc.2021.06.075 ◽

2021 ◽

Vol 5 (2) ◽

pp. 01-06

Author(s):

Selim Durmaz ◽

◽

Ömer Faruk Rahman ◽

Keyword(s):

Risk Factors ◽

Aortic Dissection ◽

Roc Analysis ◽

Circulatory Arrest ◽

Hematological Parameters ◽

Demographic Data ◽

Type A ◽

Hospital Death ◽

Acute Type ◽

Type A Aortic Dissection

Background: Mortality in acute Type A aortic dissection is still high and unpredictable. We aimed to investigate the validity of preoperative hematological markers and possible risk factors in predicting in-hospital mortality in patients operated with deep hypothermic circulatory arrest method. Methods: 78 consecutive patients who were admitted to the emergency service and operated on were retrospectively analyzed. Risk factors for in-hospital death were investigated to develop a predictive model. Results: There was no difference between patients in terms of the were demographic data of the patients. In the mortality group, only preoperative creatinine levels were found to be higher (p < 0.05). Factors affecting mortality were found as total circulatory arrest (TCA) and cross-clamp (X-clamp) times when intraoperative data were examined (p < 0.05). ROC analysis was performed to determine the power to predict mortality and to determine the cut-off point. In ROC analysis to predict mortality, X-Clamp time > 71 minutes, 68.2% sensitivity and 66.1% specificity, TCA > 44.5 minutes, 72.7% sensitivity and 73.2% specificity were found. In the mortality group, these values were found to be significantly higher than those who were discharged. Conclusion: In the surgical treatment of Type A aortic dissection under deep hypothermia, hematologic biomarkers may be insufficient in estimating the risk for mortality. Keywords: Acute; aortic dissection; biomarker; mortality

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Peri-operative risk factors for in-hospital mortality in acute type A aortic dissection

Journal of Thoracic Disease ◽

10.21037/jtd.2019.09.11 ◽

2019 ◽

Vol 11 (9) ◽

pp. 3887-3895

Author(s):

Miaoyun Wen ◽

Yongli Han ◽

Jingkun Ye ◽

Gengxin Cai ◽

Wenxin Zeng ◽

...

Keyword(s):

Risk Factors ◽

Aortic Dissection ◽

Hospital Mortality ◽

Type A ◽

Operative Risk ◽

Acute Type ◽

Type A Aortic Dissection

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Influence of Luminal Communication on Aortic Enlargement after Hemiarch Replacement for Acute Type A Aortic Dissection

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0039-1677886 ◽

2019 ◽

Vol 68 (04) ◽

pp. 294-300

Author(s):

Gaku Uchino ◽

Takeshi Yoshida ◽

Bunpachi Kakii ◽

Masato Furui

Keyword(s):

Risk Factors ◽

Growth Rate ◽

Aortic Dissection ◽

Univariate Analysis ◽

Type A ◽

Aortic Diameter ◽

Acute Type ◽

Type A Aortic Dissection ◽

Independent Risk Factors ◽

Hemiarch Replacement

Background Aortic enlargement after hemiarch replacement (HAR) for acute type A aortic dissection (AAAD) is a serious problem. We reviewed our experience and analyzed the risk factors for aortic enlargement. Methods During April 2005 to December 2017, 364 patients underwent HAR for AAAD. Seventy-three patients fulfilled the inclusion criteria. We analyzed the change in aortic diameter, aortic growth rate, and major adverse aortic events (MAAEs) and their association with luminal communication of the aortic arch. Results Anastomotic communication, supra-aortic communication (SAC), and distal aortic communication were found in 34 (46.6%), 28 (38.4%), and 20 (27.4%) patients, respectively. The aortic growth rate was high because of the presence of SAC, distal aortic communication, and the number of coexisting aortic communication. Univariate analysis showed that the presence of SAC and an initial aortic diameter > 35 mm at 20 mm distal to the left subclavian artery and at the pulmonary artery bifurcation (PAB) were risk factors for MAAEs. Multivariate analysis showed that SAC and an initial aortic diameter > 35 mm at the PAB were independent risk factors for MAAEs. Conclusion SAC, distal aortic communication, and the number of coexisting aortic communication are significant risk factors for aortic enlargement after HAR for AAAD. SAC and an initial aortic diameter > 35 mm at the PAB are independent risk factors for MAAEs after this procedure.

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