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季节和气候变化对 A 型主动脉夹层患者住院死亡率和住院时间的影响。

Effects of seasonal and climate variations on in-hospital mortality and length of stay in patients with type A aortic dissection.

机构信息

Department of Cardiovascular Surgery and Cardiac Disease Center, Union Hospital, Fujian Medical University, Fuzhou, 350001, People's Republic of China.

Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, People's Republic of China.

出版信息

J Cardiothorac Surg. 2021 Sep 8;16(1):252. doi: 10.1186/s13019-021-01639-z.

Abstract

OBJECTIVE

To investigate the effects of seasonal and climatic changes on postoperative in-hospital mortality and length of stay (LOS) in patients with type A acute aortic dissection (AAD).

METHODS

Patients undergoing implantation of the modified triple-branched stent graft to replace the descending aorta in addition to aortic root reconstruction for type A AAD in our hospital from January 2016 to December 2019 were included. Relevant data were retrospectively collected and analyzed.

RESULTS

A total of 404 patients were included in our analyses. The multivariate unconditional logistic regression analysis showed that patients admitted in autumn (OR 4.027, 95% CI 1.023-17.301, P = 0.039) or with coronary heart disease (OR 8.938, 95% CI 1.991-29.560, P = 0.049) were independently associated with an increased risk of postoperative in-hospital mortality. Furthermore, patients admitted in autumn (OR 5.956, 95% CI 2.719-7.921, P = 0.041) or with hypertension (OR 3.486, 95% CI 1.192-5.106, P = 0.035) were independently associated with an increased risk of longer LOS.

CONCLUSION

Patients admitted in autumn or with coronary heart disease are at higher risk of in-hospital mortality following surgery for type A AAD. Also, patients admitted in autumn or with hypertension have a longer hospital LOS. In the autumn of the temperature transition, we may need to strengthen the management of medical quality after surgery for type A AAD.

摘要

目的

探讨季节和气候变化对急性 A 型主动脉夹层(AAD)患者术后院内死亡率和住院时间(LOS)的影响。

方法

纳入 2016 年 1 月至 2019 年 12 月在我院接受改良三分支支架移植物置入术联合主动脉根部重建术治疗的 A 型 AAD 患者,回顾性收集相关数据并进行分析。

结果

共纳入 404 例患者,多因素非条件 logistic 回归分析显示,秋季入院(OR=4.027,95%CI:1.023-17.301,P=0.039)或合并冠心病(OR=8.938,95%CI:1.991-29.560,P=0.049)的患者术后院内死亡率增加的风险独立增加。此外,秋季入院(OR=5.956,95%CI:2.719-7.921,P=0.041)或合并高血压(OR=3.486,95%CI:1.192-5.106,P=0.035)的患者 LOS 增加的风险独立增加。

结论

秋季入院或合并冠心病的 A 型 AAD 患者术后院内死亡率较高。此外,秋季入院或合并高血压的患者 LOS 较长。在季节转换的秋季,我们可能需要加强 A 型 AAD 术后医疗质量的管理。

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