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Risk Factors for Postoperative Mortality in Patients with Acute Stanford Type A Aortic Dissection

Yan Huo1, Hui Zhang1, Bo Li1

  • 1Department of Intensive Care Unit, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.

International Journal of General Medicine
|October 28, 2021
PubMed

Insights

Obesity (body mass index ≥25 kg/m2), high SOFA scores, prolonged cardiopulmonary bypass assistance, low cardiac output, and diffuse intravascular coagulation are key risk factors for death in acute Stanford type A aortic dissection patients.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Critical Care Medicine

Background:

  • Acute Stanford type A aortic dissection (AD) is a life-threatening condition requiring prompt surgical intervention.
  • Identifying risk factors for postoperative mortality is crucial for improving patient outcomes.

Purpose of the Study:

  • To explore the independent risk factors associated with postoperative mortality in patients undergoing surgical repair for acute Stanford type A AD.

Main Methods:

  • A cohort of 149 patients with acute Stanford type A AD was analyzed.
  • Patients were divided into survival and death groups based on prognosis.
  • Univariate and multivariate logistic regression analyses were performed to identify risk factors.

Main Results:

  • Univariate analysis identified several factors correlated with mortality, including BMI ≥25 kg/m², prolonged cardiopulmonary bypass, low cardiac output, DIC, and AKI.
  • Multivariate analysis revealed independent risk factors: BMI ≥25 kg/m², SOFA score >8, cardiopulmonary bypass assistance >70 minutes, postoperative low cardiac output, and postoperative DIC.

Conclusions:

  • Obesity (BMI ≥25 kg/m²), elevated SOFA scores, extended cardiopulmonary bypass assistance, postoperative low cardiac output, and diffuse intravascular coagulation are independent predictors of mortality in acute Stanford type A AD.
  • While other factors like hepatic failure and AKI showed correlation, they were not independent risk factors.
Abstract

Keywords:
DICSOFA scoreaortic dissectionmortalityrisk factor

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