Outcome Predictors in Patients Presenting With Acute Aortic Dissection

Chen, Lingzhi; Zhou, Hao; Huang, Weijian; Guo, Zheng; Sun, Chao; Chen, Changxi; Zhao, Chuhuan; Gao, Zhan Guo

doi:10.1053/j.jvca.2016.03.149

Cited by 10 publications

(9 citation statements)

References 32 publications

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“…The acute inactivation of thyroid hormones by inner-ring deiodination is probably a beneficial adaptation during NITS, and the common belief is in favor of an attempt by the body to decrease the metabolic rate, suppress systemic energy consumption, and return to baseline as the illness resolves, thereby promoting survival (22). The proportion of ATAAD patients with low T3 levels was as high as 79.5% (70/88), which was similar to a previous report (23). However, the clinical significance of thyroid hormone levels in ATAAD has not yet been confirmed (24).…”

Section: Discussionsupporting

confidence: 87%

Thyroid Hormone Is Related to Postoperative AKI in Acute Type A Aortic Dissection

et al. 2020

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Section: Discussionsupporting

confidence: 87%

Thyroid Hormone Is Related to Postoperative AKI in Acute Type A Aortic Dissection

et al. 2020

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“…Therefore, efforts have been put to identify high-risk TAAD patients [2,3]. Several predictors of adverse events in acute aortic dissection have been discussed [4]. To our knowledge, the special impact of the white blood cell count (WBCc) on surgical outcome of acute aortic dissection remained unelucidated.…”

Section: Introductionmentioning

confidence: 99%

The elevated admission white blood cell count relates to adverse surgical outcome of acute Stanford type a aortic dissection

Shi

Xiao

et al. 2020

J Cardiothorac Surg

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Background: The purpose of the study was to examine the association between white blood cell count (WBCc) on admission and early outcome in patients with the acute Stanford type A aortic dissection (TAAD). Methods: From January 2012 to December 2018, we retrospectively evaluated a series of 331 consecutive patients underwent surgery for TAAD in Tongji Hospital. The patients were divided into 2 groups based on the WBCc, i.e. the normal WBCc group (WBCc≤11 × 10 9 /L) and leukocytosis group (WBCc> 11 × 10 9 /L). The perioperative data were compared between the 2 groups. The in-hospital mortality and the compositive adverse event including multi-organ dysfunction syndrome, postoperative stroke, tracheotomy, and re-exploration for stopping bleeding were set as end points. Cox regression were used to assess the potential risk factors. Results: The in-hospital mortality was nearly 3 time higher in the leukocytosis group than in the normal WBCc group (20.9% vs.8.1%, P = 0.001), and 15.1% overall. For the circulatory arrest, there was significant higher mortality in patients with leukocytosis than normal WBCc group (26.1%vs.8.9%, P = 0.001). After adjustment for confounding factors, the leukocytosis was found to be a strong independent predictor of in-hospital mortality (odds ratio = 3.10; 95% confidence interval 1.38 to 6.97, P = 0.006). The leukocytosis was also a risk factor of adverse events (odds ratio = 1.80; 95% confidence interval 1.07 to 3.04, P = 0.027). Conclusions: The WBCc within 24 h of admission for TAAD is a strong and independent predictor of in-hospital mortality as well as short-term clinical events. The results of this study have important clinical implications for riskstratifying patients with TAAD.

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“…The sample sizes ranged from 37 to 375, with a total of 1525 AAD patients. Three studies [ 6 , 7 , 10 ] enrolled the type A aortic dissection patients, 1 study [ 5 ] enrolled the complicated type B aortic dissection patients, and other studies [ 4 , 11 , 12 ] included all types of patients. The median/mean age of the patients ranged from 50.3 to 69 years.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies [ 7 , 11 , 12 ] reported the association between stage 3 AKI and early mortality. As shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

Postoperative acute kidney injury and early and long-term mortality in acute aortic dissection patients

Meng¹,

Li²,

Lihua³

et al. 2021

Medicine

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Objective: To evaluate the impact of postoperative acute kidney injury (AKI) on early and long-term mortality in patients with acute aortic dissection by conducting a meta-analysis. Methods: An extensive literature search was performed in PubMed and Embase databases until February 15, 2020. Observational studies that reported the associations between postoperative AKI and early (in-hospital and within 30 days) or long-term mortality in patients with acute aortic dissection were included. Results: Seven studies comprising 1525 acute aortic dissection patients were identified. A random effect meta-analysis showed that postoperative AKI was significantly associated with higher risk of long-term mortality (risk ratio [RR] 2.32; 95% confidence interval [CI] 1.50–3.59). Subgroup analysis revealed that the pooled RR of long-term mortality was 1.42 (95% CI 0.90–2.22) for stage 1 AKI, 1.72 (95% CI 0.95–3.12) for stage 2 AKI, and 4.46 (95% CI 2.72–7.32) for stage 3 AKI, respectively. Furthermore, postoperative stage 3 AKI was associated with an increased risk of early mortality (RR 11.3; 95% CI 4.2–30.5). Conclusions: This meta-analysis provided clinical evidence that postoperative stage 3 AKI is associated with higher risk of early and long-term mortality, even after adjusting important confounding factors. However, the current findings should be interpreted with caution due to the retrospective nature and limited number of studies analyzed.

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Outcome Predictors in Patients Presenting With Acute Aortic Dissection

Abstract: T3 was downregulated in acute aortic dissection. Low T3 level was a risk factor for in-hospital death and acute renal failure in patients with acute aortic dissection.

Cited by 10 publications

References 32 publications

Thyroid Hormone Is Related to Postoperative AKI in Acute Type A Aortic Dissection

Thyroid Hormone Is Related to Postoperative AKI in Acute Type A Aortic Dissection

The elevated admission white blood cell count relates to adverse surgical outcome of acute Stanford type a aortic dissection

Postoperative acute kidney injury and early and long-term mortality in acute aortic dissection patients

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