Perioperative risk factors predict one-year mortality in patients with acute type-A aortic dissection

Yanwei Yang,Jiaqi Tong,Mu Jin,Jiayi Xue,Huixian Li

doi:10.1186/s13019-020-01296-8

Abstract

ObjectiveThe goal of this study was to analyze perioperative risk factors to predict one- year mortality after operation for acute type A aortic dissection (AAD).MethodsA 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.ResultsMultivariable 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).ConclusionIn 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.

Highlights

Acute type-A aortic dissection (ATAAD) is a deadly cardiovascular event, and emergency surgery is typically indicated but associated with a 5–25% mortality rate [1,2,3]
This investigation provides insights into the one-year mortality rate following an operation for ATAAD to analyze the perioperative risk factors that predict short-term mortality
Materials and methods The data used in this study were acquired from a previous clinical trial (ClinicalTrials.gov number: NCT01894334) [9], and the procedures were approved by the Beijing Anzhen Hospital Clinical Research Ethics Committee

Summary

Introduction

Acute type-A aortic dissection (ATAAD) is a deadly cardiovascular event, and emergency surgery is typically indicated but associated with a 5–25% mortality rate [1,2,3]. Several predictors of short-term adverse events in acute aortic dissection have been investigated, including age [4], female predispositions [5], prolonged mechanical ventilation [6], hypotension [7], and impaired renal function [8]. Our previous study showed that postoperative mortality was less than one year (6) This investigation provides insights into the one-year mortality rate following an operation for ATAAD to analyze the perioperative risk factors that predict short-term mortality. University, Beijing 100050, China 2Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical. University, Beijing Institute of Heart Lung and Blood Vessel Diseases, and Beijing Engineering Research Center of Vascular Prostheses, Beijing 100029, China.

Methods

Results

Conclusion