Perioperative Risk Factors for Post-operative Pneumonia after Type A Acute Aortic Dissection Surgery

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Critical Care Medicine

Background:

• Type A acute aortic dissection (TAAAD) carries high mortality, with significant in-hospital deaths and post-operative complications.
• Post-operative pneumonia (POP) is a major cause of morbidity and mortality in TAAAD survivors.
• Identifying POP risk factors is crucial for improving outcomes in TAAAD patients.

Purpose of the Study:

• To determine the prevalence of post-operative pneumonia (POP) in patients who underwent surgery for Type A acute aortic dissection (TAAAD).
• To identify independent risk factors associated with the development of POP in this patient cohort.
• To provide data for clinical decision-making to enhance the prognosis of TAAAD survivors.

Main Methods:

• Retrospective analysis of 89 TAAAD patients treated surgically at Tongji Hospital from December 2020 to July 2021.
• Collection and analysis of perioperative data and patient outcomes.
• Logistic regression analysis to identify independent risk factors for POP.

Main Results:

• The incidence of POP was 31.5% among TAAAD patients.
• POP was associated with increased oxygenation damage, pneumothorax, reintubation, tracheotomy, renal replacement therapy, arrhythmia, and gastrointestinal bleeding.
• Independent risk factors for POP included smoking, elevated preoperative white blood cells, and intraoperative transfusion. In-hospital mortality was 2.3%.

Conclusions:

• Post-operative pneumonia significantly worsens outcomes for patients undergoing TAAAD surgery.
• Patients with identified risk factors require vigilant monitoring and management to mitigate POP risk.
• Proactive identification and management of risk factors can improve TAAAD patient prognosis.