Analysis of early death risk factors and nursing experience of acute type A aortic dissection undergoing root repair surgery

Li Jinsong; Guo Hong; Duan Weixun; Liu Jincheng; Sun Jingwei

doi:10.13498/j.cnki.chin.j.ecc.2024.04.04

Abstract：Objective To analyze the risk factors of early postoperative death in patients with acute Stanford type A aortic dissection(ATAAD)and the key points of early nursing care.Methods A retrospective analysis was performed on 281 patients with ATAAD who underwent aortic root repair surgery at the First Affiliated Hospital of Air Force Military Medical University between December 2018 and June 2022.Baseline data,laboratory examination indicators and imaging indicators were used as independent variables,survival during in-hospital/postoperative 30-day was used as dependent variable to divide the patients into survival group(n=251)and death group(n=30).Univariate analysis and multivariate logistic regression analysis were performed.Results A total of 281 patients were enrolled in this study,and in-hospital/postoperative 30-day mortality rate was 10.7%.Univariate analysis showed that there were significant differences in age,previous cerebrovascular accident,previous cardiogenic shock,preoperative monocyte count,preoperative prothrombin time,aspartate aminotransferase,alanine aminotransferase,D-dimer,cerebral malperfusion and renal malperfusion between the survival group and the death group(P<0.05).Multivariate logistic regression analysis showed that preoperative cerebrovascular accident,preoperative monocyte count,preoperative D-dimer and preoperative cerebral malperfusion were independent risk factors for in-hospital/postoperative 30-day mortality.Conclusion Doctors and nurses should focus on the independent risk factors for in-hospital/postoperative 30-day mortality,and cooperate to actively prevent,early diagnosis and care for these risk factors.