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

Zhigang Wang,Lichong Lu,Tao Chen,Dongjin Wang,Lifang Zhang,Min Ge,Pingping Ge

doi:10.1186/s13019-021-01702-9

Abstract

ObjectiveThis study aimed to identify risk factors for 30-day mortality in patients who received DeBakey type I aortic dissection (AD) repair surgery.MethodsA 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.ResultsOur 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.ConclusionsOur 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.

Highlights

Acute DeBakey type I aortic dissection (AD) is a cardiovascular emergency event that often leads to poor prognosis
In terms of laboratory parameters, serum creatine, D-dimer, and international normalized ratio level upon admission were increased while the preoperative albumin and fibrinogen levels were significantly decreased in non-survivors compared to survivors
The deep hypothermic circulatory arrest time was similar between both groups

Summary

Introduction

Acute DeBakey type I aortic dissection (AD) is a cardiovascular emergency event that often leads to poor prognosis. Emergency surgery has been proved to be the most effective treatment once acute type I AD is diagnosed. In the past 10 years, with the advancement of surgical technology, the mortality rate during type A AD (TAAD) surgery has been greatly reduced from 23.2 to 4.9% [2,3,4,5,6,7,8]. The risk factors for 30-day mortality in type I AD had not been well determined. We retrospectively reviewed 830 consecutive acute type I AD patients who received TAAD surgery to explore risk factors for in-hospital death

Methods

Results

Discussion

Conclusion