Risk factors of transient neurological dysfunction in adults after aortic arch operation

Li Haicheng; Pan Xudong; Chen Yu; Ma Qiannan; Zheng Jun; Liu Yongmin; Sun Lizhong; Zheng Sihong

doi:10.3760/j.issn.1673-4777.2018.05.010

Abstract：Objective To analyze the risk factors of transient neurological dysfunction (TND) in adults after aortic arch operation.Methods Clinical records of 159 adult patients who had aortic arch operation with moderate hypothermic circulatory arrest from January to September 2017 in Beijing Anzhen Hospital,Capital Medical University were retrospectively analyzed;TND occurred in 52 patients after operation.Clinical data and operative data were analyzed between TND group(n =52) and non-TND group(n =107);risk factors of TND were analyzed by logistic regression.Results Acute aortic disease ratio,emergency operation ratio,preoperative leucocyte count,neutrophil percentage,blood glucose level,intraoperative cardiopulmonary bypass times and aortic occlusion time,postoperative blood sodium,blood glucose,blood lactic acid,erythrocyte suspension infusion volume,mechanical ventilation time and intensive care unit stay time in TND group were significantly higher/more/longer than those in non-TND group;postoperative hematocrit in TND group was significantly lower than that in non-TND group (all P ＜ 0.05).Logistic regression analysis showed that emergency operation [odds ratio(OR) =2.927,95％ confidence interval(CI):1.326-6.463,P =0.008],elevated level of preoperative blood glucose(OR =1.662,95％ CI:1.239-2.229,P =0.001) and increased times of intraoperative cardiopulmonary bypass(OR =1.127,95％ CI:1.012-1.256,P =0.030) were independent risk factors of TND.Conclusion Emergency operation,elevated level of preoperative blood glucose and increased times of intraoperative cardiopulmonary bypass are independent risk factors of TND after aortic arch operation.