Abstract
We sought to assess the effect of postoperative renal failure (RF) on outcomes of acute type A aortic dissection (ATAAD) and identify predictors of chronic kidney disease (CKD) following ATAAD. This retrospective single-center analysis included all adults with ATAAD from 2011 to 2023. Patients were stratified into RF and no RF groups. Logistic regression analyses were performed to identify predictors of CKD. A linear mixed effect regression model was created to identify the differences in glomerular filtration rate (GFR) change over time. A total of 515 patients comprising 39.6% women were included in this analysis. Estimated GFR at admission was lower in the RF group (59 vs. 65mL/min/1.73m2, P=0.04) while 30-day mortality was higher in the RF group (17.4% vs. 6.5%, P<0.01). Rates of postoperative pneumonia (16.8% vs. 6.8%, P<0.01), atrial fibrillation (61.1% vs. 30.8%, P<0.01), and sepsis (6.3 vs. 1.5%, P<0.01) were higher in the RF group. Creatinine at admission (odds ratio [OR]: 3.133, 95% confidence interval [CI] 1.539-6.379, P<0.01) was associated with higher odds of developing CKD at 1year. Creatinine at admission (OR: 2.512, 95% CI 1.035-6.096, P=0.04), and atrial fibrillation (OR: 3.698, 95% CI 1.237-11.056, P=0.02) were associated with higher odds of developing CKD at 5years. ATAAD-related postoperative RF is associated with significant morbidity and mortality; however, it is not predictive of CKD. Creatinine at admission was the most consistent predictor of CKD development at 1 and 5years post-ATAAD.
Published Version
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