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急性A型主动脉夹层患者水合状态受损对术后院内死亡的影响。

Influence of Impaired Hydration Status on Postoperative in-Hospital Death in Patients with Acute Type A Aortic Dissection.

作者信息

Chen Yaqin, Peng Yanchun, Zhang Xuecui, Chen Liangwan, Lin Yanjuan

机构信息

School of Nursing, Fujian Medical University, Fuzhou, People's Republic of China.

Department of Nursing, Union Hospital of Fujian Medical University, Fuzhou, People's Republic of China.

出版信息

Int J Gen Med. 2023 Sep 29;16:4419-4428. doi: 10.2147/IJGM.S426612. eCollection 2023.

Abstract

BACKGROUND

The hydration state of the body is getting more and more attention from researchers. The purpose of this study is to investigate the relationship between impaired hydration status and postoperative hospitalization death in patients with A AAD.

METHODS

From January 2019 to October 2021, the clinical data of 299 patients undergoing A AAD surgery were retrospectively analyzed. Patients were divided into normal hydration group, imminent dehydration group and current dehydration group according to the dehydration standard at admission. Univariate and multivariate logistic regression analysis were used to determine the independent risk factors for in-hospital death of patients with A AAD.

RESULTS

Postoperative in-hospital death in A AAD patients was significantly more common in the imminent and current dehydration groups (>295mmol/L) (26.7% vs 11.9%; =0.001). The length of ICU stay was significantly longer in the impending and current dehydration groups (<0.05). After controlling for other factors by multivariate logistic regression analysis, the results showed that the group of impending and current dehydration (>295) (OR=3.61, 95% confidence interval [CI]: 1.61-8.06; =0.002), CRRT (OR=10.55, 95%[CI]: 3.59-31.01; <0.001), lactic acid (OR=1.25, 95%[CI]: 1.13-1.38; <0.001), CAD (OR=5.27, 95%[CI]: 1.12-24.80; =0.035) was an independent risk factor for in-hospital death in A AAD patients. Albumin (OR=0.92, 95%[CI]: 0.85-0.99; =0.040) is a protective factor.

CONCLUSION

The presence of high serum osmotic pressure on admission of A AAD patients can independently predict postoperative death, and the impaired body hydration status should be paid attention to.

摘要

背景

机体的水合状态越来越受到研究者的关注。本研究旨在探讨急性主动脉夹层(A AAD)患者水合状态受损与术后住院死亡之间的关系。

方法

回顾性分析2019年1月至2021年10月期间299例行A AAD手术患者的临床资料。根据入院时的脱水标准将患者分为正常水合组、即将脱水组和当前脱水组。采用单因素和多因素logistic回归分析确定A AAD患者院内死亡的独立危险因素。

结果

A AAD患者术后院内死亡在即将脱水组和当前脱水组(>295mmol/L)中明显更为常见(26.7%对11.9%;P=0.001)。即将脱水组和当前脱水组的ICU住院时间明显更长(P<0.05)。通过多因素logistic回归分析控制其他因素后,结果显示即将脱水组和当前脱水组(>295)(OR=3.61,95%置信区间[CI]:1.61-8.06;P=0.002)、连续性肾脏替代治疗(CRRT)(OR=10.55,95%[CI]:3.59-31.01;P<0.001)、乳酸(OR=1.25,95%[CI]:1.13-1.38;P<0.001)、冠状动脉疾病(CAD)(OR=5.27,95%[CI]:1.12-24.80;P=0.035)是A AAD患者院内死亡的独立危险因素。白蛋白(OR=0.92,95%[CI]:0.85-0.99;P=0.040)是一个保护因素。

结论

A AAD患者入院时高血清渗透压的存在可独立预测术后死亡,应关注机体水合状态受损情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/319b/10547000/35ce6df7278d/IJGM-16-4419-g0001.jpg

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