Zhang Jing, Jiang Yujuan, Gao Chao, Feng Jun, Wang Ailing
Department of Cardiovascular, the First Affiliated Hospital of An Hui Medical University, He Fei, China; Department of Cardiovascular, the Second People Hospital of He Fei, He Fei, China.
Department of Cardiovascular, the First Affiliated Hospital of An Hui Medical University, He Fei, China.
Heart Lung Circ. 2015 Apr;24(4):348-53. doi: 10.1016/j.hlc.2014.10.009. Epub 2014 Nov 1.
To determine the risk factors leading to hospital death with acute aortic dissection (AAD) patients and then to develop a simple risk prediction model to identify patients at increased risk of hospital death.
A total of 360 patients with AAD were enrolled. Thirty risk factors were used in the statistical analysis for predicting hospital death. Risk factors for hospital death were investigated with univariate and multiple logistic regression analysis.
The hospital mortality rate was 21.4% (77 of 360 patients). Univariate analysis revealed 12 risk factors to be statistically significant predictors of hospital death (P<0.05). Multiple logistic regression analysis identified that type A (OR, 10.53; P=0.001), hypotension (OR, 5.72; P=0.04), syncope (OR, 8.24; P=0.03), ischaemic complications (OR, 4.67; P=0.05), renal dysfunction (OR, 31.32; P<0.001), and neutrophil percentage ≥80% (OR, 5.67; P=0.01) were significant predictors of in-hospital death. With the simple prediction model, a total score of 4 offered the best point value.
Independent risk factors for hospital death can be predicted with AAD patients. The risk prediction model could be used to identify the prognosis and to quickly determine the therapeutic technique for AAD patients.
确定急性主动脉夹层（AAD）患者导致院内死亡的危险因素，并建立一个简单的风险预测模型，以识别院内死亡风险增加的患者。
共纳入360例AAD患者。30个危险因素用于预测院内死亡的统计分析。采用单因素和多因素logistic回归分析研究院内死亡的危险因素。
院内死亡率为21.4%（360例患者中的77例）。单因素分析显示12个危险因素是院内死亡的统计学显著预测因素（P<0.05）。多因素logistic回归分析确定，A型（比值比[OR]，10.53；P=0.001）、低血压（OR，5.72；P=0.04）、晕厥（OR，8.24；P=0.03）、缺血性并发症（OR，4.67；P=0.05）、肾功能不全（OR，31.32；P<0.001）和中性粒细胞百分比≥80%（OR，5.67；P=0.01）是院内死亡的显著预测因素。对于这个简单的预测模型，总分4分提供了最佳的分值。
AAD患者院内死亡的独立危险因素可以被预测。该风险预测模型可用于识别AAD患者的预后，并快速确定其治疗技术。
