Novel risk factors for the healthcare associated infections (HAIs) in patients with Stanford type A aortic dissection (TAAD).

Abstract

Risk factors for healthcare associated infections (HAIs) following surgical repair of acute type A aortic dissection (TAAD) has not been well defined. This was a retrospective study of patients treated between Jan 2013 and May 2016 at the large tertiary teaching hospital in Jiangsu, China. Logistic regression analysis was performed to investigate the association patients with acute TAAD who underwent ascending aortic and arch replacement under deep hypothermic circulatory arrest (DHCA) and healthcare associated infections during hospitalization. Of the final 210 patients with aortic dissection (AD) admitted to our hospital, 100 patients had TAAD (100/210, 47.62%), which were then allocated to the HAIs group (n=36) and Non-HAIs group (n=64). We found that DCHA >29 min [odds ratio (OR) =2.60, 95% confidential interval (CI), 1.01-6.80, P=0.048], preoperative PLT <171×109/L (OR =3.62; 95% CI, 1.33-9.79; P=0.011) and D-dimer >4.25 mg/L (OR =2.83; 95% CI, 1.07-7.47; P=0.035) were independently associated with the occurrence of HAIs for the patients with TAAD following surgical repair. Hosmer-Lemeshow statistic of the model suggested perfect model discrimination from a perfect fit (χ2=4.77, P=0.6883). Logistic model was verified when the area under receiver operating characteristic (ROC) curve was equal to 0.7665. TAAD patients with longer DHCA time, lower preoperative PLT, higher serum D-dimer would significantly increase the risks after surgical repair of arch replacement.