Perioperative risk factors predict one-year mortality in patients with acute type-A aortic dissection

Abstract

Objective The goal of this study was to analyze perioperative risk factors to predict one- year mortality after operation for acute type A aortic dissection (AAD). Methods A total of 121 consecutive patients undergoing Stanford type A AAD surgery in Beijing Anzhen Hospital were enrolled. Preoperative clinical and laboratory data from patients were collected. Results Multivariable Cox regression analysis showed that significant factors associated with increased one-year mortality were elder age (year) (hazard ratio (HR) 1.0985; 95% confidence interval (CI) 1.0334–1.1677), intraoperative blood transfusion ≥2000 mL (HR 8.8081; 95% CI 2.3319–33.2709), a higher level of serum creatinine (μmol/L) at postoperative one day (HR 1.0122; 95% CI 1.0035–1.0190) and oxygenation index (OI) < 200 (mmHg) at the end of surgery (HR 5.7575; 95% CI 1.1695–28.3458). Conclusion In this study, perioperative risk factors to predict one-year prognosis are age, intraoperative blood transfusion ≥2000 mL, postoperative OI < 200 mmHg and level of postoperative serum creatinine. The results aid in the comprehension of surgical outcomes and assist in the optimization of treatment strategies for those with perioperative risk factors to decrease one-year mortality.

Risk factors for postoperative acute kidney injury in overweight patients with acute type A aortic dissection

“…In this study, suspended red blood cell infusion was an independent risk factor for postoperative AKI in overweight ATAAD patients ( P = 0.015). This is consistent with previous research [ 25 , 26 ]. It may be related to postoperative ischemia–reperfusion injury in patients undergoing cardiopulmonary bypass surgery [ 27 ].…”

Systemic immune‐inflammation index predicted short‐term outcomes in ATAD patients undergoing surgery

“…Identifying preoperative predictors for poor outcomes is of utmost importance to stratify ATAD patients suitable for surgery. Previous study has identified several preoperative factors that predict poor outcomes in ATAD patients, 8 but EuroSCORE II was pointed out to be not accurate when applied for thoracic aortic dissection surgery. 9 And there was no preoperative risk evaluation system involving acute systemic inflammation factors for postoperative prognostic assessment.…”