Effects of seasonal and climate variations on in-hospital mortality and length of stay in patients with type A aortic dissection

Abstract

Objective To investigate the effects of seasonal and climatic changes on postoperative in-hospital mortality and length of stay (LOS) in patients with type A acute aortic dissection (AAD). Methods Patients undergoing implantation of the modified triple-branched stent graft to replace the descending aorta in addition to aortic root reconstruction for type A AAD in our hospital from January 2016 to December 2019 were included. Relevant data were retrospectively collected and analyzed. Results A total of 404 patients were included in our analyses. The multivariate unconditional logistic regression analysis showed that patients admitted in autumn (OR 4.027, 95% CI 1.023–17.301, P = 0.039) or with coronary heart disease (OR 8.938, 95% CI 1.991–29.560, P = 0.049) were independently associated with an increased risk of postoperative in-hospital mortality. Furthermore, patients admitted in autumn (OR 5.956, 95% CI 2.719–7.921, P = 0.041) or with hypertension (OR 3.486, 95% CI 1.192–5.106, P = 0.035) were independently associated with an increased risk of longer LOS. Conclusion Patients admitted in autumn or with coronary heart disease are at higher risk of in-hospital mortality following surgery for type A AAD. Also, patients admitted in autumn or with hypertension have a longer hospital LOS. In the autumn of the temperature transition, we may need to strengthen the management of medical quality after surgery for type A AAD.

The intervention seasons of thoracic endovascular aortic repair impacted the outcomes for patients with type B aortic dissection

“…A previous study has shown that the onset of TAAD in autumn may be a factor that raises in-hospital mortality ( 10 ). Luo et al found that patients admitted in autumn had an increased risk of in-hospital death following surgery for TAAD ( 11 ). However, previous scholarship failed to establish the contrast between the outcomes of TEVAR operated in spring and autumn.…”

“…The possible mechanisms are as follows: In contrast to previous studies ( 10 , 11 ), patients with TAAD usually require open surgery, and a warmer climate after surgery is critical for massive invasive healing ( 11 ). Therefore, autumn is more dangerous for TAAD patients.…”

“…In this context, seasonal variations may also impact the aortic remodeling and outcomes of AD patients after surgery. A few previous studies have indicated that the start of symptoms and the season of admission raise the risk of in-hospital mortality in patients with type A aortic dissection (TAAD) ( 10 , 11 ). However, it remains unclear whether the chronobiology of TEVAR intervention affects the prognosis of TBAD patients.…”

Myocardial Priority Promotes Cardiovascular Recovery for Acute Type A Aortic Dissection Combined with Coronary Artery Disease Undergoing Aortic Arch Surgery

“…From the 1970s to the present, the proportion of ATAAD surgery combined with CAD has been high (20~30%) [ 21 ], while that combined with CABG is not high (5.6~7.5%) [ 22 ], and many articles indicate that CABG increases mortality [ 23 , 24 ]. Therefore, exploring new surgical strategies to improve the prognosis of ATAAD combined with CAD is clinically significant.…”

Effects of lipoprotein(a) in aortic dissection patients and acute myocardial infarction patients with chest pain: A Cross-sectional Study

“…AD is a life-threatening disease with a prevalence of about 6 cases per 100000 person-years in a large population (3). The accidence rate of aortic dissection is estimated to rise due to circadian and seasonal variation (4,5). In addition, multiple risk factors were involved in AD development, including hypertension(6), male gender, and an average age of around 70 (7).…”