Preoperative and Intraoperative Predictors of Direct Home Discharge in Patients with Acute Type A Aortic Dissection: A Single-Center Retrospective Observational Study.

PURPOSE: This study aimed to identify the preoperative and intraoperative predictors of direct home discharge in patients following surgical repair for acute type A aortic dissection (ATAAD).

METHODS

We included patients with ATAAD who underwent surgical repair between 2012 and 2025. Patients were categorized into 2 groups based on their discharge destination. Multivariable logistic regression analysis was performed to identify independent predictors of direct home discharge.

RESULTS

Among 277 patients, 133 (48.01%) were discharged directly home. Multivariable logistic regression analysis revealed that age (per year, odds ratio [OR], 0.961; 95% confidence interval [CI], 0.936-0.986; P = 0.003), living alone (OR, 0.523; 95% CI, 0.277-0.985; P = 0.045), cardiac tamponade (OR, 0.434; 95% CI, 0.203-0.927; P = 0.031), and neurological deficits of the extremities (OR, 0.369; 95% CI, 0.161-0.845; P = 0.018) were significant independent predictors of direct home discharge. The area under the receiver operating characteristic curve was 0.731.

CONCLUSION

Advanced age, living alone, preoperative cardiac tamponade, and neurological deficits of the extremities are significant predictors of a reduced likelihood of direct home discharge following surgical repair for ATAAD.