Perioperative risk factors predict one-year mortality in patients with acute type-A aortic dissection
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(2020) 15:249
RESEARCH ARTICLE
Open Access
Perioperative risk factors predict one-year mortality in patients with acute type-A aortic dissection Yanwei Yang1,2†, Jiayi Xue2,3†, Huixian Li4†, Jiaqi Tong1† and Mu Jin1,2*
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. Keywords: Acute type a aortic dissection, Short-term mortality, Perioperative risk factor
Background Acute type-A aortic dissection (ATAAD) is a deadly cardiovascular event, and emergency surgery is typically indicated but associated with a 5–25% mortality rate [1–3]. Several predictors of short-term adverse events in acute aortic dissection have been investigated, including age [4], female predispositions [5],
prolonged mechanical ventilation [6], hypotension [7], and impaired renal function [8]. Our previous study showed that postoperative mortality was less than one year (6). Thus this investigation provides insights into the one-year mortality rate following an operation for ATAAD to analyze the perioperative risk factors that predict short-term mortality.
* Correspondence: [email protected] † Yanwei Yang, Jiayi Xue, Huixian Li and Jiaqi Tong contributed equally to this work. 1 Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China 2 Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, and Beijing Engineering Research Center of Vascular Prostheses, Beijing 100029, China Full list of author information is available at the end of the article
Materials and methods The data used in this study were acquired from a previous clinical trial (ClinicalTrials.gov number: NCT01894334) [9], and the procedures were approved by the Beijing Anzhen Hospital Clinical Research Ethics Committee. Informed consent was obtaine
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