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行 Debakey Ⅰ型主动脉夹层修复术患者 30 天死亡率的危险因素。

Risk factors for 30-day mortality in patients who received DeBakey type I aortic dissection repair surgery.

机构信息

Department of Cardio-Thoracic Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Zhongshan Road 321, Nanjing, 210008, China.

Department of General Practice, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.

出版信息

J Cardiothorac Surg. 2021 Oct 30;16(1):320. doi: 10.1186/s13019-021-01702-9.

Abstract

OBJECTIVE

This study aimed to identify risk factors for 30-day mortality in patients who received DeBakey type I aortic dissection (AD) repair surgery.

METHODS

A total of 830 consecutive patients who received acute DeBakey type I AD surgery between 2014 and 2019 were included in the study. The associations between 30-day mortality and perioperative parameters were examined in order to identify risk factors.

RESULTS

Our data suggested that the overall 30-day mortality rate of all enrolled patients was 11.7%. Unsurprisingly, non-survivors were older and more frequently accompanied with histories of cardiovascular diseases. For intraoperative parameters, the prevalence of coronary artery bypass grafting and cardiopulmonary bypass times were increased in non-survivors. In addition, acute kidney injury (AKI), dialysis, stroke, and deep sternal wound infection were more commonly seen among non-survivors. The multivariate logistic regression analysis suggested that cardiovascular disease history, preoperative D-dimer level, drainage volume 24 h after surgery, and postoperative AKI were independent risk factors for 30-day mortality after DeBakey type I aortic dissection repair surgery.

CONCLUSIONS

Our study demonstrated that cardiovascular disease history, preoperative D-dimer level, drainage volume 24 h after surgery as well as postoperative AKI were risk factors for 30-day mortality after DeBakey type I aortic dissection repair surgery.

摘要

目的

本研究旨在确定接受 Debakey Ⅰ型主动脉夹层(AD)修复手术患者 30 天死亡率的危险因素。

方法

本研究纳入了 2014 年至 2019 年期间接受急性 Debakey Ⅰ型 AD 手术的 830 例连续患者。为了确定危险因素,研究人员检查了围手术期参数与 30 天死亡率之间的关联。

结果

我们的数据表明,所有纳入患者的总体 30 天死亡率为 11.7%。不出所料,非幸存者年龄更大,且更常伴有心血管疾病史。在术中参数方面,非幸存者中冠状动脉旁路移植术和体外循环时间的发生率增加。此外,非幸存者中急性肾损伤(AKI)、透析、中风和深部胸骨伤口感染更为常见。多变量逻辑回归分析表明,心血管疾病史、术前 D-二聚体水平、术后 24 小时引流量以及术后 AKI 是 Debakey Ⅰ型主动脉夹层修复手术后 30 天死亡率的独立危险因素。

结论

本研究表明,心血管疾病史、术前 D-二聚体水平、术后 24 小时引流量以及术后 AKI 是 Debakey Ⅰ型主动脉夹层修复手术后 30 天死亡率的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5f4/8557494/26db47b41688/13019_2021_1702_Fig1_HTML.jpg

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