Clinical Analysis of Risk Factors for Mortality in Type A Acute Aortic Dissection: A Single Study From China
Objective: Acute type A aortic dissection (ATAAD) is a fatal condition that requires emergency surgery. The aim of the present study was to determine pre- and intra-operative risk factors for in-hospital mortality in patients with ATAAD.Methods: Consecutive 313 patients with ATAAD who underwent emer...
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Frontiers Media S.A.
2021
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oai:doaj.org-article:404149a184c94708b941f5ec7a4af54f2021-11-04T06:26:15ZClinical Analysis of Risk Factors for Mortality in Type A Acute Aortic Dissection: A Single Study From China2297-055X10.3389/fcvm.2021.728568https://doaj.org/article/404149a184c94708b941f5ec7a4af54f2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.728568/fullhttps://doaj.org/toc/2297-055XObjective: Acute type A aortic dissection (ATAAD) is a fatal condition that requires emergency surgery. The aim of the present study was to determine pre- and intra-operative risk factors for in-hospital mortality in patients with ATAAD.Methods: Consecutive 313 patients with ATAAD who underwent emergency surgery at our hospital from February 2012 to February 2017 were enrolled in our study. Univariate and multivariate logistic regression analysis were performed to identify the pre-operative and intra-operative risk factors for in-hospital mortality.Results: Of the 313 patients, 32 patients (10.2%) died. Compared with survivors, non-survivors had higher heart rate, serum potassium level and EuroSCORE II, and higher incidence of moderate to severe pericardial effusion, supra-aortic vessels involvement, myocardial ischemia and lower-extremity ischemia. As for surgery-related factors, the duration of surgery and cardiopulmonary bypass time were longer in non-survivors than survivors. In addition, non-survivors were more likely to undergo coronary-artery bypass graft compared with survivors. On multivariate analysis, elevated plasma potassium level (OR: 43.0, 95% CI: 3.8–51.5, p < 0.001), high incidence of supra-aortic vessels involvement (OR: 4.4, 95% CI: 1.5–7.0, p = 0.008) and lower-extremity ischemia (OR: 4.9, 95% CI: 1.6–6.9; p = 0.009), and longer duration of surgery (OR 6.0, 95% CI: 1.8–18.7, p = 0.000) and cardiopulmonary bypass time (OR: 3.7, 95% CI: 1.3–9.3, p = 0.001) were independently predictive of higher mortality in patients with ATAAD.Conclusions: Supra-aortic vessels involvement, lower-extremity ischemia and elevated plasma potassium level are independent predictors of mortality in patients with ATAAD. A significant decrease in duration of surgery and cardiopulmonary bypass time is helpful to improve survival of patients.Hongliang YuanHongliang YuanZhenxing SunZhenxing SunYongxing ZhangYongxing ZhangWenqian WuWenqian WuManwei LiuManwei LiuYali YangYali YangJing WangJing WangQing LvQing LvLi ZhangLi ZhangYuman LiYuman LiMingxing XieMingxing XieFrontiers Media S.A.articleacute type A aortic dissectionsurgerymortalityrisk factorsretrospectiveDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021) |
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acute type A aortic dissection surgery mortality risk factors retrospective Diseases of the circulatory (Cardiovascular) system RC666-701 |
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acute type A aortic dissection surgery mortality risk factors retrospective Diseases of the circulatory (Cardiovascular) system RC666-701 Hongliang Yuan Hongliang Yuan Zhenxing Sun Zhenxing Sun Yongxing Zhang Yongxing Zhang Wenqian Wu Wenqian Wu Manwei Liu Manwei Liu Yali Yang Yali Yang Jing Wang Jing Wang Qing Lv Qing Lv Li Zhang Li Zhang Yuman Li Yuman Li Mingxing Xie Mingxing Xie Clinical Analysis of Risk Factors for Mortality in Type A Acute Aortic Dissection: A Single Study From China |
| description |
Objective: Acute type A aortic dissection (ATAAD) is a fatal condition that requires emergency surgery. The aim of the present study was to determine pre- and intra-operative risk factors for in-hospital mortality in patients with ATAAD.Methods: Consecutive 313 patients with ATAAD who underwent emergency surgery at our hospital from February 2012 to February 2017 were enrolled in our study. Univariate and multivariate logistic regression analysis were performed to identify the pre-operative and intra-operative risk factors for in-hospital mortality.Results: Of the 313 patients, 32 patients (10.2%) died. Compared with survivors, non-survivors had higher heart rate, serum potassium level and EuroSCORE II, and higher incidence of moderate to severe pericardial effusion, supra-aortic vessels involvement, myocardial ischemia and lower-extremity ischemia. As for surgery-related factors, the duration of surgery and cardiopulmonary bypass time were longer in non-survivors than survivors. In addition, non-survivors were more likely to undergo coronary-artery bypass graft compared with survivors. On multivariate analysis, elevated plasma potassium level (OR: 43.0, 95% CI: 3.8–51.5, p < 0.001), high incidence of supra-aortic vessels involvement (OR: 4.4, 95% CI: 1.5–7.0, p = 0.008) and lower-extremity ischemia (OR: 4.9, 95% CI: 1.6–6.9; p = 0.009), and longer duration of surgery (OR 6.0, 95% CI: 1.8–18.7, p = 0.000) and cardiopulmonary bypass time (OR: 3.7, 95% CI: 1.3–9.3, p = 0.001) were independently predictive of higher mortality in patients with ATAAD.Conclusions: Supra-aortic vessels involvement, lower-extremity ischemia and elevated plasma potassium level are independent predictors of mortality in patients with ATAAD. A significant decrease in duration of surgery and cardiopulmonary bypass time is helpful to improve survival of patients. |
| format |
article |
| author |
Hongliang Yuan Hongliang Yuan Zhenxing Sun Zhenxing Sun Yongxing Zhang Yongxing Zhang Wenqian Wu Wenqian Wu Manwei Liu Manwei Liu Yali Yang Yali Yang Jing Wang Jing Wang Qing Lv Qing Lv Li Zhang Li Zhang Yuman Li Yuman Li Mingxing Xie Mingxing Xie |
| author_facet |
Hongliang Yuan Hongliang Yuan Zhenxing Sun Zhenxing Sun Yongxing Zhang Yongxing Zhang Wenqian Wu Wenqian Wu Manwei Liu Manwei Liu Yali Yang Yali Yang Jing Wang Jing Wang Qing Lv Qing Lv Li Zhang Li Zhang Yuman Li Yuman Li Mingxing Xie Mingxing Xie |
| author_sort |
Hongliang Yuan |
| title |
Clinical Analysis of Risk Factors for Mortality in Type A Acute Aortic Dissection: A Single Study From China |
| title_short |
Clinical Analysis of Risk Factors for Mortality in Type A Acute Aortic Dissection: A Single Study From China |
| title_full |
Clinical Analysis of Risk Factors for Mortality in Type A Acute Aortic Dissection: A Single Study From China |
| title_fullStr |
Clinical Analysis of Risk Factors for Mortality in Type A Acute Aortic Dissection: A Single Study From China |
| title_full_unstemmed |
Clinical Analysis of Risk Factors for Mortality in Type A Acute Aortic Dissection: A Single Study From China |
| title_sort |
clinical analysis of risk factors for mortality in type a acute aortic dissection: a single study from china |
| publisher |
Frontiers Media S.A. |
| publishDate |
2021 |
| url |
https://doaj.org/article/404149a184c94708b941f5ec7a4af54f |
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