Risk factors analysis for preoperative hypoxemia in patients with Stanford type A aortic dissection

Abstract

Objective To investigate the risk factors for preoperative hypoxemia in patients with Stanford type A aortic dissection. Methods The clinical data of 203 patients with Stanford type A aortic dissection were retrospectively analyzed. The patients were divided into hypoxemia group (oxygenation index ≤ 200 mmHg, 1 mmHg=0.133 kPa, 51 cases) and non hypoxemia group (oxygenation index> 200 mmHg, 152 cases). The independent risk factors were identified by binary Logistic regression analysis. Results The incidence of preoperative hypoxemia in patients with Stanford type A was 25.12% (51/203). The univariate analysis result showed that hypertension grading, diabetes, pulmonary artery velocity, degree of aortic insufficiency, extent of aortic dissection, albumin, fibrinogen and hemoglobin levels were the risk factors for preoperative hypoxemia in patients with Stanford type A aortic dissection. The binary Logistic regression analysis result showed that degree of aortic insufficiency and extents of aortic dissection were independent risk factors for preoperative hypoxemia in patients with Stanford type A aortic dissection (OR = 1.369, 95% CI:1.059-1.771, P = 0.017; OR = 1.557, 95% CI:1.090-2.225, P = 0.015), and the albumin and hemoglobin levels were protective factors (OR = 0.915, 95% CI:0.860-0.975, P = 0.006; OR = 0.983, 95% CI: 0.968-1.000, P = 0.044). Conclusions The incidence of preoperative hypoxemia in patients with Stanford type A is high. The degree of aortic insufficiency and extents of aortic dissection are independent risk factors for preoperative hypoxemia in patients with Stanford type A aortic dissection, and the albumin and hemoglobin levels are protective factors. Key words: Aortic diseases; Anoxia; Risk factors; Retrospective studies