Occurrence and influencing factors of severe adverse prognosis within 30 d after surgery in patients with acute type A aortic dissection
SUN Haosen
LIU Ziqi
TENG Fei
Abstract：Objective To observe the occurrence of severe adverse prognosis within 30 d after surgery in patients with acute type A aortic dissection(ATAAD)and to analyze the influencing factors,providing a scientific basis for clinical diagnosis and treatment.Methods A retrospective analysis was conducted on 799 patients who underwent total aortic arch replacement and stent elephant trunk surgery(Sun's procedure).Severe adverse prognosis within 30 d after surgery were defined as death,acute respiratory distress syndrome,tracheotomy,acute renal failure,acute liver dysfunction,acute stroke,or paraplegia.The clinical data of patients with and without severe adverse prognosis within 30 d after sur-gery were compared,and multivariate Logistic regression analysis was used to screen the influencing factors of severe ad-verse prognosis within 30 d after surgery in ATAAD patients.Results Among the 799 ATAAD patients,215(26.90%)experienced severe adverse prognosis within 30 d after surgery.There were statistical differences in age,history of cerebro-vascular disease,proportion of pericardial tamponade at admission,cardiopulmonary bypass time,and the proportion of preoperative coronary,cerebral,renal,and limb malperfusion between patients with and without severe adverse prognosis within 30 d after surgery(all P<0.05).Multivariate Logistic regression analysis showed that age,history of cerebrovascu-lar disease,pericardial tamponade at admission,preoperative coronary malperfusion,preoperative cerebral malperfusion,preoperative renal malperfusion,preoperative limb malperfusion,and cardiopulmonary bypass time were independent risk factors for severe adverse prognosis within 30 d after surgery in ATAAD patients(all P<0.05).Conclusions The inci-dence of severe adverse prognosis within 30 d after surgery in ATAAD patients is 26.90%.Advanced age,history of cere-brovascular disease,pericardial tamponade at admission,cardiopulmonary bypass time,and preoperative organ malperfu-sion are risk factors for severe adverse prognosis within 30 d after surgery in ATAAD patients.
Keywords：acute type A aortic dissectionadverse prognosisrisk factorcardiopulmonary bypass timeorgan malperfusion
Publication Date：2025-08-25
Online Publishing Date：2025-09-10(First online date of this platform, not the publication date of the document)
Pages：5( 90-94 )