Journal of thoracic disease · 2025
Prognostic factors and outcomes of acute type A aortic dissection: a retrospective clinical study.
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Li Haochao, Chen Pengfei, Zhao Diming, Chen Mingjian, Chen Liang, Sun Xiaogang, Qian Xiangyang, Wang Shaoye, Chen Zujun, Wang Liqing
Аннотация
BACKGROUND: Acute type A aortic dissection (aTAAD) is a cardiovascular emergency requiring surgical intervention. Data on the long-term mortality of surgically treated patients remain scarce. We aimed to examine the prognostic factors and long-term outcomes of surgically treated patients with aTAAD.
METHODS: We analyzed data from 952 surgically treated aTAAD patients. The association between the perioperative factors and long-term mortality of these patients was examined.
RESULTS: Altogether, 93 patients died during the follow-up period, resulting in a 5-year mortality rate of 9.7%. The patients who died were older (P=0.02), had averagely higher European System for Cardiac Operative Risk Evaluation (EuroSCORE) II scores (P=0.042), longer cardiopulmonary bypass time (CPBT) (P=0.003), and tended to have postoperative kidney dysfunction (P=0.002) and postoperative cerebral accident (P=0.01). Univariate analysis revealed that age, intensive care unit stay, ventilation use, CPBT, albumin (both at admission and post-surgery), and creatinine (post-surgery) were also significantly associated with long-term mortality. After adjusting for the EuroSCORE II score in the multivariate analysis, only low albumin (both at admission and post-surgery) and high creatinine (post-surgery) levels remained as independent predictors of long-term mortality.
CONCLUSIONS: The EuroSCORE II score could be useful in predicting the long-term mortality of surgically treated aTAAD patients. Low albumin (both at admission and post-surgery) and high creatinine (post-surgery) levels are also important predictors.
METHODS: We analyzed data from 952 surgically treated aTAAD patients. The association between the perioperative factors and long-term mortality of these patients was examined.
RESULTS: Altogether, 93 patients died during the follow-up period, resulting in a 5-year mortality rate of 9.7%. The patients who died were older (P=0.02), had averagely higher European System for Cardiac Operative Risk Evaluation (EuroSCORE) II scores (P=0.042), longer cardiopulmonary bypass time (CPBT) (P=0.003), and tended to have postoperative kidney dysfunction (P=0.002) and postoperative cerebral accident (P=0.01). Univariate analysis revealed that age, intensive care unit stay, ventilation use, CPBT, albumin (both at admission and post-surgery), and creatinine (post-surgery) were also significantly associated with long-term mortality. After adjusting for the EuroSCORE II score in the multivariate analysis, only low albumin (both at admission and post-surgery) and high creatinine (post-surgery) levels remained as independent predictors of long-term mortality.
CONCLUSIONS: The EuroSCORE II score could be useful in predicting the long-term mortality of surgically treated aTAAD patients. Low albumin (both at admission and post-surgery) and high creatinine (post-surgery) levels are also important predictors.