What Is the Most Influential Factor Affecting Severe Respiratory Failure in Uncomplicated Acute Type B Aortic...

Area of Science:

• Cardiovascular Medicine
• Pulmonary Medicine
• Critical Care

Background:

• Acute Stanford Type B aortic dissection (TBAD) can lead to severe respiratory failure.
• Identifying predictors for respiratory support is crucial for managing TBAD patients.

Purpose of the Study:

• To determine the most influential factors associated with respiratory failure requiring respiratory assist devices (RADs) in uncomplicated acute TBAD patients.

Main Methods:

• Retrospective analysis of 97 patients with uncomplicated acute TBAD.
• Categorization into RAD and non-RAD groups.
• Statistical analysis including multivariable logistic regression and structural equation modeling.

Main Results:

• Patients requiring RAD were younger, had higher BMI, more patent false lumens, and significantly higher white blood cell (WBC) counts post-admission.
• An elevated WBC count (≥11,100/μL) on the day after admission independently predicted the need for RAD (OR 6.17).
• Structural equation modeling confirmed the significant association between elevated WBC count and RAD requirement.

Conclusions:

• Elevated WBC count is the most influential factor predicting respiratory failure and the need for RAD in uncomplicated acute TBAD.
• Early identification of high WBC counts may help anticipate respiratory compromise in TBAD patients.