scholarly journals Risk factors for 30-day mortality in patients who received DeBakey type I aortic dissection repair surgery

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zhigang Wang ◽  
Tao Chen ◽  
Pingping Ge ◽  
Min Ge ◽  
Lichong Lu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Aortic Dissection ◽  
Artery Bypass ◽  
Multivariate Logistic Regression Analysis ◽  
Deep Sternal Wound Infection ◽  
Type I ◽  
Drainage Volume ◽  
Postoperative Aki ◽  
D Dimer

Abstract Objective This study aimed to identify risk factors for 30-day mortality in patients who received DeBakey type I aortic dissection (AD) repair surgery. Methods A total of 830 consecutive patients who received acute DeBakey type I AD surgery between 2014 and 2019 were included in the study. The associations between 30-day mortality and perioperative parameters were examined in order to identify risk factors. Results Our data suggested that the overall 30-day mortality rate of all enrolled patients was 11.7%. Unsurprisingly, non-survivors were older and more frequently accompanied with histories of cardiovascular diseases. For intraoperative parameters, the prevalence of coronary artery bypass grafting and cardiopulmonary bypass times were increased in non-survivors. In addition, acute kidney injury (AKI), dialysis, stroke, and deep sternal wound infection were more commonly seen among non-survivors. The multivariate logistic regression analysis suggested that cardiovascular disease history, preoperative D-dimer level, drainage volume 24 h after surgery, and postoperative AKI were independent risk factors for 30-day mortality after DeBakey type I aortic dissection repair surgery. Conclusions Our study demonstrated that cardiovascular disease history, preoperative D-dimer level, drainage volume 24 h after surgery as well as postoperative AKI were risk factors for 30-day mortality after DeBakey type I aortic dissection repair surgery.

Risk factors for cardiovascular disease in children with type I diabetes: Part II

1997 ◽  
Vol 12 (6) ◽  
pp. 318-322 ◽  
Author(s):  
Terri H. Lipman ◽  
Laura L. Hayman ◽  
Carolyn E. Fabian
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Type I Diabetes ◽  
Type I

scholarly journals Age-Related Differences in the Time Course of Coagulation and Fibrinolytic Parameters in Patients with Traumatic Brain Injury

2020 ◽  
Vol 21 (16) ◽  
pp. 5613
Author(s):  
Ryuta Nakae ◽  
Yu Fujiki ◽  
Yasuhiro Takayama ◽  
Takahiro Kanaya ◽  
Yutaka Igarashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Propensity Score ◽  
Older Patients ◽  
Multivariate Logistic Regression Analysis ◽  
The Elderly ◽  
Elderly Group ◽  
Post Injury ◽  
D Dimer

Coagulopathy and older age are common and well-recognized risk factors for poorer outcomes in traumatic brain injury (TBI) patients; however, the relationships between coagulopathy and age remain unclear. We hypothesized that coagulation/fibrinolytic abnormalities are more pronounced in older patients and may be a factor in poorer outcomes. We retrospectively evaluated severe TBI cases in which fibrinogen and D-dimer were measured on arrival and 3–6 h after injury. Propensity score-matched analyses were performed to adjust baseline characteristics between older patients (the “elderly group,” aged ≥75 y) and younger patients (the “non-elderly group,” aged 16–74 y). A total of 1294 cases (elderly group: 395, non-elderly group: 899) were assessed, and propensity score matching created a matched cohort of 324 pairs. Fibrinogen on admission, the degree of reduction in fibrinogen between admission and 3–6 h post-injury, and D-dimer levels between admission and 3–6 h post-injury were significantly more abnormal in the elderly group than in the non-elderly group. On multivariate logistic regression analysis, independent risk factors for poor prognosis included low fibrinogen and high D-dimer levels on admission. Posttraumatic coagulation and fibrinolytic abnormalities are more severe in older patients, and fibrinogen and D-dimer abnormalities are negative predictive factors.

scholarly journals Immunosuppression as a Risk Factor for De Novo Angiotensin II Type Receptor Antibodies Development after Kidney Transplantation

2021 ◽  
Vol 10 (22) ◽  
pp. 5390
Author(s):  
Bogdan Marian Sorohan ◽  
Ioanel Sinescu ◽  
Dorina Tacu ◽  
Cristina Bucșa ◽  
Corina Țincu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Angiotensin Ii ◽  
De Novo ◽  
Multivariate Logistic Regression Analysis ◽  
Study Cohort ◽  
Type I ◽  
Factors Associated ◽  
Maintenance Immunosuppression ◽  
Receptor Antibodies

(1) Background: Angiotensin II type I receptor antibodies (AT1R-Ab) represent a topic of interest in kidney transplantation (KT). Data regarding the risk factors associated with de novo AT1R-Ab development are lacking. Our goal was to identify the incidence of de novo AT1R-Ab at 1 year after KT and to evaluate the risk factors associated with their formation. (2) Methods: We conducted a prospective cohort study on 56 adult patients, transplanted between 2018 and 2019. Recipient, donor, transplant, treatment, and complications data were assessed. A threshold of >10 U/mL was used for AT1R-Ab detection. (3) Results: De novo AT1R-Ab were observed in 12 out of 56 KT recipients (21.4%). The median value AT1R-Ab in the study cohort was 8.5 U/mL (inter quartile range: 6.8–10.4) and 15.6 U/mL (10.8–19.8) in the positive group. By multivariate logistic regression analysis, induction immunosuppression with anti-thymocyte globulin (OR = 7.20, 95% CI: 1.30–39.65, p = 0.02), maintenance immunosuppression with immediate-release tacrolimus (OR = 6.20, 95% CI: 1.16–41.51, p = 0.03), and mean tacrolimus trough level (OR = 2.36, 95% CI: 1.14–4.85, p = 0.01) were independent risk factors for de novo AT1R-Ab at 1 year after KT. (4) Conclusions: De novo AT1R-Ab development at 1 year after KT is significantly influenced by the type of induction and maintenance immunosuppression.

scholarly journals Clinical characteristics and risk factors of Fulminant Mycoplasma pneumoniae pneumonia in children

2020 ◽  
Author(s):  
yaoyao ling ◽  
Tongqiang Zhang ◽  
Zhenli Zhu ◽  
Jiao Tian ◽  
yongsheng xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pleural Effusion ◽  
Mycoplasma Pneumoniae ◽  
Clinical Characteristics ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Multivariate Logistic Regression Analysis ◽  
Radiological Findings ◽  
Mycoplasma Pneumoniae Pneumonia ◽  
D Dimer

Abstract BACKGROUND: Analyze the clinical characteristics of Fulminant Mycoplasma pneumoniae pneumonia (FMPP), and explore the related factors predicting FMPP. METHODS: A retrospective case-control study was performed on 345 children with Mycoplasma pneumoniae pneumonia (MPP) hospitalized in our Hospital from January 2017 to June 2019. The clinical features, laboratory data and radiological findings were compared between the FMPP group, refractory Mycoplasma pneumoniae pneumonia (RMPP)group and general Mycoplasma pneumoniae pneumonia (GMPP) group. RESULTS: FMPP patients (n=69) had more severe presentations, higher incidence of extra-pulmonary complications and more serious radiological findings(P<0.05). And the days of fever and the days in hospital were longer, and FMPP patients also need more complicated treatments(P<0.05). Meanwhile, the levels of white blood cell count(WBC) ,C-reactive protein(CRP), lactic dehydrogenase (LDH), interleukin (IL)-6,ferritin, D-dimer, fibrinogen(FG),alanine aminotransferase(ALT) and the percentage of neutrophils in the FMPP group were significantly higher than those in the RMPP group and the GMPP group (both P<0.05). In ROC curve analysis, the percentage of neutrophils, WBC, CRP, LDH, IL-6, ferritin, D-dimer and ALT were contributed to identify FMPP patients. Multivariate logistic regression analysis showed that ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion had significant predictive effects on the early diagnosis of FMPP (P<0.01). Conclusion: FMPP patients presented more serious clinical manifestations. Ferritin>174.15 ng/mL, IL-6>25.475pg/ml and pleural effusion were high risk factors for FMPP.

scholarly journals Risk factors for and outcomes of prolonged mechanical ventilation in patients received DeBakey type I aortic dissection repairment

2021 ◽  
Vol 13 (2) ◽  
pp. 735-742
Author(s):  
Min Ge ◽  
Zhigang Wang ◽  
Tao Chen ◽  
Yongqing Cheng ◽  
Jiaxin Ye ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Aortic Dissection ◽  
Prolonged Mechanical Ventilation ◽  
Type I

scholarly journals Association of Biomarkers Related to Preoperative Inflammatory and Coagulation with Postoperative In-Hospital Deaths in Patients with Type A Acute Aortic Dissection

2021 ◽  
Author(s):  
Ming Li ◽  
Haifeng Sun ◽  
Suochun Xu ◽  
Yang Yan ◽  
Haichen Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Predictive Value ◽  
Multivariate Logistic Regression Analysis ◽  
Type A ◽  
Hospital Deaths ◽  
Independent Risk Factors ◽  
D Dimer

Abstract Background: The aim of this study was to analyze the predictive value of biomarkers related to preoperative inflammatory and coagulation in the prognosis of patients with type A acute aortic dissection (AAD). Methods: A total of 206 patients with type A AAD who had received surgical treatment were enrolled. Patients were divided into two groups according to whether they died during hospitalization. Peripheral blood samples were collected before anesthesia induction. Preoperative levels of D-dimer, fibrinogen (FIB), platelet (PLT), white blood cells (WBC) and neutrophil (NEU) between the two groups were compared. Univariate and multivariate logistic regression analysis were utilized to identify the independent risk factors for postoperative in-hospital deaths of patients with type A AAD. Receiver operating characteristic (ROC) curve were used to analyze the predictive value of D-dimer, FIB, PLT, WBC, NEU and CRP in the prognosis of the patients. Results: Univariate logistic regression analysis showed that the P values of the five parameters including D-dimer, FIB, PLT, WBC and NEU were all less than 0.1, which may be risk factors for postoperative in-hospital deaths of patients with type A AAD. Further multivariate logistic regression analysis indicated that higher preoperative D-dimer and WBC levels were independent risk factors for in-hospital deaths of patients with type A AAD. ROC curve analysis indicated that FIB+PLT combination is provided with the highest predictive value for in-hospital deaths.Conclusion: Both preoperative D-dimer and WBC in patients with type A AAD may be used as independent risk factors for the prognosis of such patients. Combined use of FIB and PLT may improve the accuracy and accessibility of clinical prognostic assessment.

scholarly journals Prognostic Value of Neutrophil to Lymphocyte Ratio and Risk Factors for Mortality in Patients with Stanford Type A Aortic Dissection

2017 ◽  
Vol 20 (3) ◽  
pp. 119 ◽  
Author(s):  
Kursad Oz ◽  
Taner Iyigun ◽  
Zeynep Karaman ◽  
Ömer Çelik ◽  
Ertan Akbay ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Aortic Dissection ◽  
Neutrophil To Lymphocyte Ratio ◽  
Control Group ◽  
Operating Characteristics ◽  
Short Term ◽  
Lymphocyte Ratio ◽  
Wide Range ◽  
Short Term Mortality

Background: Neutrophil to lymphocyte ratio (NLR) is a prognostic predictor in a wide range of cardiovascular disease. Acute aortic dissection (AD) is an uncommon but fatal cardiovascular disease. In this study, we investigated both prognostic factors in patients with AD and whether NLR can be a predictor for mortality. Methods: We analyzed retrospectively the data of 57 patients with AD who had undergone emergent surgery in our hospital and included 128 consecutive patients with chest pain admitted to the emergency room as a control group. Also, patients who were operated on due to aortic dissection as another subgroup were compared to NLR values. Baseline clinical features, cardiovascular risk factors, and surgical and laboratory parameters were obtained from the hospital database. Results: Patients with AD had higher NLR than the control group (1.7 ± 0.5 versus 7.6 ± 3.3, P < .001). In the AD group, 15 deaths occurred and non-survivors had significantly higher NLR, compared to survivors (11.6 ± 2.4 versus 6.6 ± 2.3, P < .001). In multivariate analysis, high NLR (odds ratio [OR] 1.913, 95% CI 1.030-1.081, P = .04) and cross-clamp time (OR 1.265, 95% CI 1.003-1.596, P = .04) were determined as independent predictors of in-hospital mortality. In receiver operating characteristics curve analyses, the NLR > 9.3 predicted the mortality in AD with a specificity of 91% and a sensitivity of 86% (P < .001).Conclusion: This study shows that high NLR can be used as a marker for prognosis in short-term mortality of patient with AD. Additionally, increased lactate level in perioperative period, prolonged cardiopulmonary bypass time, and additional cardiac procedures are strong independent predictors of short-term mortality in patients with acute AD.

scholarly journals Characteristics and outcomes of Stanford type A aortic dissection patients with post-operation severe hyperbilirubinemia: a retrospective cohort study

2020 ◽  
Author(s):  
Xiaolan Chen ◽  
Ming Bai ◽  
Lijuan Zhao ◽  
Yangping Li ◽  
Yan Yu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Aortic Dissection ◽  
Hospital Mortality ◽  
Multivariate Logistic Regression Analysis ◽  
Kidney Injury ◽  
Type A ◽  
Type A Aortic Dissection ◽  
Post Operation ◽  
Severe Hyperbilirubinemia

Abstract Background Hyperbilirubinemia is one of the common complications after cardiac surgery and is associated with increased mortality. However, to the best of our knowledge, the report on clinical significance of postoperative severe hyperbilirubinemia in Stanford type A aortic dissection (AAD) patients is limited. Methods Patients who underwent surgical treatment for AAD in our center between January 2015 and December 2018 were retrospectively screened. In-hospital mortality, long-term mortality, acute kidney injury (AKI), and the requirement of continuous renal replacement therapy (CRRT) were assessed as endpoints. Univariate and multivariate regression models were employed to identify the risk factors of these endpoints. Results 271 (12.3%) patients were included. Of the included patients, 222 (81.9%) experienced postoperative AKI, and 50 (18.5%) received CRRT. In-hospital mortality was 30.3%. The 1-year, 2-year, and 3-year cumulative mortality were 32.9%, 33.9%, and 35.3%, respectively. Multivariate Logistic regression analysis indicated that age (P < 0.033), AKI stage 3 (P < 0.001), the amount of blood transfusion after surgery (P = 0.019), mean arterial pressure (MAP) in the first postoperative day (P = 0.012), the use of extracorporeal membrane oxygenation (ECMO) (P = 0.02), and the peak total bilirubin (TB) concentration (P = 0.023) were independent risk factors of in-hospital mortality. The optimal cut-off value of peak TB on predicting in-hospital mortality was 121.2 µmol/l. Survival analysis showed significantly decreased survival for patients who developed severe, rather than mild, hyperbilirubinemia. Conclusions Post-operation severe hyperbilirubinemia is a common clinical presentation in AAD surgery patients. Post-operation severe hyperbilirubinemia AAD patients with older age, lower MAP, increased blood transfusion, stage 3 AKI, the use of ECMO, and the increased peak TB had higher risk of in-hospital mortality.

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