术后血小板计数低可能是急性A型主动脉夹层患者3年死亡率的一个危险因素。
Low postoperative blood platelet count may be a risk factor for 3-year mortality in patients with acute type A aortic dissection.
作者信息
Liu Guangyu, Wang Hongbai, Luo Qipeng, Cao Liang, Yang Lijing, Yu Cuntao, Yan Fuxia, Yuan Su
机构信息
Anesthesia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167 North Lishi Road, Xicheng District, Beijing, 100037, China.
Pain Medicine Center, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.
出版信息
J Cardiothorac Surg. 2021 Sep 27;16(1):274. doi: 10.1186/s13019-021-01623-7.
BACKGROUND
Mortality and complications remain high after acute type A aortic dissection (ATAAD) open surgery and are associated with coagulation dysfunction. Platelets play an important role in the process of coagulation. This study explored the relationship between postoperative platelet counts and 3-year mortality after operation in patients with ATAAD undergoing open aortic repair surgery.
METHODS
Patients with ATAAD who underwent Total Arch Replacement and Frozen Elephant Trunk in Fuwai Hospital from 2011 to 2015 were selected for this study. The perioperative data were collected and sorted through the electronic clinical case system. Multivariate Logistic regression was used to analyze the risk factors for death within three years after surgery.
RESULTS
A total of 495 patients were included in the analysis. After correction for confounding factors, decreased postoperative platelet count remained an independent factor that was associated with lower mortality (OR = 0.918, 95% CI 0.853-0.988, P = 0.023).
CONCLUSIONS
The study indicated that decreased postoperative platelet count may lead to increased 3-year mortality, in patients with ATAAD who underwent open aortic repair surgery.
背景
急性A型主动脉夹层（ATAAD）开放手术后死亡率和并发症仍然很高，且与凝血功能障碍有关。血小板在凝血过程中起重要作用。本研究探讨了接受主动脉开放修复手术的ATAAD患者术后血小板计数与术后3年死亡率之间的关系。
方法
选取2011年至2015年在阜外医院接受全弓置换和象鼻支架植入术的ATAAD患者进行本研究。通过电子临床病例系统收集和整理围手术期数据。采用多因素Logistic回归分析术后3年内死亡的危险因素。
结果
共有495例患者纳入分析。校正混杂因素后，术后血小板计数降低仍然是与较低死亡率相关的独立因素（OR = 0.918，95%CI 0.853 - 0.988，P = 0.023）。
结论
该研究表明，接受主动脉开放修复手术的ATAAD患者术后血小板计数降低可能导致3年死亡率增加。
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