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Abstract
Acute aortic syndrome (AAS) can be life-threatening owing to a variety of complications, and it is managed in the intensive care unit (ICU). Although Stanford type-B AAS may involve hypoxemia, its predictors are not yet clearly understood. We studied clinical factors and imaging parameters for predicting hypoxemia after the onset of type-B AAS. We retrospectively analyzed patients diagnosed with type-B AAS in our hospital between January 2012 and April 2020. We defined hypoxemia as PaO2/FiO2 ≤ 200 within 7 days after AAS onset and used logistic regression analysis to evaluate prognostic factors for hypoxemia. We analyzed 224 consecutive patients (140 males, mean age 70 ± 14 years) from a total cohort of 267 patients. Among these, 53 (23.7%) had hypoxemia. The hypoxemia group had longer ICU and hospital stays compared with the non-hypoxemia group (median 20 vs. 16 days, respectively; p = 0.039 and median 7 vs. 5 days, respectively; p < 0.001). Male sex (odds ratio [OR] 2.87; 95% confidence interval [CI] 1.24–6.63; p = 0.014), obesity (OR 2.36; 95% CI 1.13–4.97; p = 0.023), patent false lumen (OR 2.33; 95% CI 1.09–4.99; p = 0.029), and high D-dimer level (OR 1.01; 95% CI 1.00–1.02; p = 0.047) were independently associated with hypoxemia by multivariate logistic analysis. This study showed a significant difference in duration of ICU and hospital stays between patients with and without hypoxemia. Furthermore, male sex, obesity, patent false lumen, and high D-dimer level may be significantly associated with hypoxemia in patients with type-B AAS.
Highlights
Acute aortic syndrome (AAS) can be life-threatening owing to a variety of complications, and it is managed in the intensive care unit (ICU)
The mechanism underlying hypoxemia that occurs after AAS has not yet been elucidated, it has been reported that the durations of ICU and hospital stays are prolonged in patients with hypoxemia[7,8,9,10,11]
The peak C-reactive protein (CRP) level is not known at the onset of AAS; it cannot be used for risk stratification for hypoxemia at the time of admission
Summary
Acute aortic syndrome (AAS) can be life-threatening owing to a variety of complications, and it is managed in the intensive care unit (ICU). We studied clinical factors and imaging parameters for predicting hypoxemia after the onset of type-B AAS. Male sex, obesity, patent false lumen, and high D-dimer level may be significantly associated with hypoxemia in patients with type-B AAS. The mechanism underlying hypoxemia that occurs after AAS has not yet been elucidated, it has been reported that the durations of ICU and hospital stays are prolonged in patients with hypoxemia[7,8,9,10,11]. The peak CRP level is not known at the onset of AAS; it cannot be used for risk stratification for hypoxemia at the time of admission. We evaluated predictive factors for hypoxemia in patients with type-B AAS based on their clinical variables at the time of admission
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