Risk factors for in-hospital mortality after total arch procedure in patients with acute type A aortic dissection
ObjectKnowledge about the risk factors of in-hospital mortality for acute type A aortic dissection (ATAAD) patients who received total arch procedure is limited. This study aims to investigate preoperative and intraoperative risk factors of in-hospital mortality of these patients.MethodsFrom May 201...
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| Format: | Article |
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1149907/full |
| _version_ | 1797840011949768704 |
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| author | Zhao An Zhao An Keng Zhong Yangyong Sun Lin Han Zhiyun Xu Bailing Li |
| author_facet | Zhao An Zhao An Keng Zhong Yangyong Sun Lin Han Zhiyun Xu Bailing Li |
| author_sort | Zhao An |
| collection | DOAJ |
| description | ObjectKnowledge about the risk factors of in-hospital mortality for acute type A aortic dissection (ATAAD) patients who received total arch procedure is limited. This study aims to investigate preoperative and intraoperative risk factors of in-hospital mortality of these patients.MethodsFrom May 2014 to June 2018, 372 ATAAD patients received the total arch procedure in our institution. These patients were divided into survival and death groups, and patients` in-hospital data were retrospectively collected. Receiver operating characteristic curve analysis was adopted to determine the optimal cut-off value of continuous variables. Univariate and multivariable logistic regression analyses were used to detect independent risk factors for in-hospital mortality.ResultsA total of 321 patients were included in the survival group and 51 in the death group. Preoperative details showed that patients in the death group were older (55.4 ± 11.7 vs. 49.3 ± 12.6, P = 0.001), had more renal dysfunction (29.4% vs. 10.9%, P = 0.001) and coronary ostia dissection (29.4% vs. 12.2%, P = 0.001), and decreased left ventricular ejection fraction (LVEF) (57.5 ± 7.9% vs. 59.8 ± 7.3%, P = 0.032). Intraoperative results showed that more patients in the death group experienced concomitant coronary artery bypass grafting (35.3% vs. 15.3%, P = 0.001) with increased cardiopulmonary bypass (CPB) time (165.7 ± 39.0 vs. 149.4 ± 35.8 min, P = 0.003), cross-clamp time (98.4 ± 24.5 vs. 90.2 ± 26.9 min, P = 0.044), and red blood cell transfusion (913.7 ± 629.0 vs. 709.7 ± 686.6 ml, P = 0.047). Logistic regression analysis showed that age >55 years, renal dysfunction, CPB time >144 min, and RBC transfusion >1,300 ml were independent risk factors for in-hospital mortality in patients with ATAAD.ConclusionIn the present study, we identified that older age, preoperative renal dysfunction, long CPB time, and intraoperative massive transfusion were risk factors for in-hospital mortality in ATAAD patients with the total arch procedure. |
| first_indexed | 2024-04-09T16:06:23Z |
| format | Article |
| id | doaj.art-70192718872c42dfb1e3fbe48fff01d3 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-09T16:06:23Z |
| publishDate | 2023-04-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-70192718872c42dfb1e3fbe48fff01d32023-04-25T05:09:57ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-04-011010.3389/fcvm.2023.11499071149907Risk factors for in-hospital mortality after total arch procedure in patients with acute type A aortic dissectionZhao An0Zhao An1Keng Zhong2Yangyong Sun3Lin Han4Zhiyun Xu5Bailing Li6Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Cardiovascular Surgery, Changhai Hospital, Naval Medical University, Shanghai, ChinaDepartment of Cardiovascular Surgery, Changhai Hospital, Naval Medical University, Shanghai, ChinaDepartment of Cardiothoracic Surgery, Affiliated People's Hospital of Jiangsu University, Zhenjiang, ChinaDepartment of Cardiovascular Surgery, Changhai Hospital, Naval Medical University, Shanghai, ChinaDepartment of Cardiovascular Surgery, Changhai Hospital, Naval Medical University, Shanghai, ChinaDepartment of Cardiovascular Surgery, Changhai Hospital, Naval Medical University, Shanghai, ChinaObjectKnowledge about the risk factors of in-hospital mortality for acute type A aortic dissection (ATAAD) patients who received total arch procedure is limited. This study aims to investigate preoperative and intraoperative risk factors of in-hospital mortality of these patients.MethodsFrom May 2014 to June 2018, 372 ATAAD patients received the total arch procedure in our institution. These patients were divided into survival and death groups, and patients` in-hospital data were retrospectively collected. Receiver operating characteristic curve analysis was adopted to determine the optimal cut-off value of continuous variables. Univariate and multivariable logistic regression analyses were used to detect independent risk factors for in-hospital mortality.ResultsA total of 321 patients were included in the survival group and 51 in the death group. Preoperative details showed that patients in the death group were older (55.4 ± 11.7 vs. 49.3 ± 12.6, P = 0.001), had more renal dysfunction (29.4% vs. 10.9%, P = 0.001) and coronary ostia dissection (29.4% vs. 12.2%, P = 0.001), and decreased left ventricular ejection fraction (LVEF) (57.5 ± 7.9% vs. 59.8 ± 7.3%, P = 0.032). Intraoperative results showed that more patients in the death group experienced concomitant coronary artery bypass grafting (35.3% vs. 15.3%, P = 0.001) with increased cardiopulmonary bypass (CPB) time (165.7 ± 39.0 vs. 149.4 ± 35.8 min, P = 0.003), cross-clamp time (98.4 ± 24.5 vs. 90.2 ± 26.9 min, P = 0.044), and red blood cell transfusion (913.7 ± 629.0 vs. 709.7 ± 686.6 ml, P = 0.047). Logistic regression analysis showed that age >55 years, renal dysfunction, CPB time >144 min, and RBC transfusion >1,300 ml were independent risk factors for in-hospital mortality in patients with ATAAD.ConclusionIn the present study, we identified that older age, preoperative renal dysfunction, long CPB time, and intraoperative massive transfusion were risk factors for in-hospital mortality in ATAAD patients with the total arch procedure.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1149907/fullacute type A aortic dissectionin-hospital mortalitytotal arch procedurerisk factors, surgical repair |
| spellingShingle | Zhao An Zhao An Keng Zhong Yangyong Sun Lin Han Zhiyun Xu Bailing Li Risk factors for in-hospital mortality after total arch procedure in patients with acute type A aortic dissection Frontiers in Cardiovascular Medicine acute type A aortic dissection in-hospital mortality total arch procedure risk factors, surgical repair |
| title | Risk factors for in-hospital mortality after total arch procedure in patients with acute type A aortic dissection |
| title_full | Risk factors for in-hospital mortality after total arch procedure in patients with acute type A aortic dissection |
| title_fullStr | Risk factors for in-hospital mortality after total arch procedure in patients with acute type A aortic dissection |
| title_full_unstemmed | Risk factors for in-hospital mortality after total arch procedure in patients with acute type A aortic dissection |
| title_short | Risk factors for in-hospital mortality after total arch procedure in patients with acute type A aortic dissection |
| title_sort | risk factors for in hospital mortality after total arch procedure in patients with acute type a aortic dissection |
| topic | acute type A aortic dissection in-hospital mortality total arch procedure risk factors, surgical repair |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1149907/full |
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