Mao Zhi-Jie, Wen Wei-Wei, Han Yi-Chen, Dong Wei-Hua, Shen Li-Juan, Huang Zhou-Qing, Xie Qiang-Li
The Key Laboratory of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Cardiovascular Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Front Cardiovasc Med. 2023 Mar 8;10:1126889. doi: 10.3389/fcvm.2023.1126889. eCollection 2023.
The aim of this study is to assess the influence of cardiopulmonary coupling (CPC) based on RCMSE on the prediction of complications and death in patients with acute type A aortic dissection (ATAAD).
The cardiopulmonary system may be nonlinearly regulated, and its coupling relationship with postoperative risk stratification in ATAAD patients has not been studied.
This study was a single-center, prospective cohort study (ChiCTR1800018319). We enrolled 39 patients with ATAAD. The outcomes were in-hospital complications and all-cause readmission or death at 2 years.
Of the 39 participants, 16 (41.0%) developed complications in the hospital, and 15 (38.5%) died or were readmitted to the hospital during the two-year follow-up. When CPC-RCMSE was used to predict in-hospital complications in ATAAD patients, the AUC was 0.853 ( < 0.001). When CPC-RCMSE was used to predict all-cause readmission or death at 2 years, the AUC was 0.731 ( < 0.05). After adjusting for age, sex, ventilator support (days), and special care time (days), CPC-RCMSE remained an independent predictor of in-hospital complications in patients with ATAAD [adjusted OR: 0.8 (95% CI, 0.68-0.94)].
CPC-RCMSE was an independent predictor of in-hospital complications and all-cause readmission or death in patients with ATAAD.
本研究旨在评估基于相对循环模型标准误差（RCMSE）的心肺耦合（CPC）对急性A型主动脉夹层（ATAAD）患者并发症及死亡预测的影响。
心肺系统可能受到非线性调节，其与ATAAD患者术后风险分层的耦合关系尚未得到研究。
本研究为单中心前瞻性队列研究（ChiCTR1800018319）。我们纳入了39例ATAAD患者。观察指标为住院期间并发症以及2年内全因再入院或死亡情况。
39名参与者中，16例（41.0%）在医院发生并发症，15例（38.5%）在两年随访期间死亡或再次入院。当使用CPC-RCMSE预测ATAAD患者住院期间并发症时，曲线下面积（AUC）为0.853（P<0.001）。当使用CPC-RCMSE预测2年内全因再入院或死亡时，AUC为0.731（P<0.05）。在调整年龄、性别、呼吸机支持时间（天）和特级护理时间（天）后，CPC-RCMSE仍然是ATAAD患者住院期间并发症的独立预测因素[调整后比值比：0.8（95%置信区间，0.68-0.94）]。
CPC-RCMSE是ATAAD患者住院期间并发症以及全因再入院或死亡的独立预测因素。
