超重的急性 A 型主动脉夹层患者术后肝功能障碍的危险因素。

Risk factors for postoperative hepatic dysfunction in overweight patients with acute type A aortic dissection.

机构信息

Panzhihua Central Hospital, 34 Yikang St, Panzhihua, Sichuan Province, 617000, China.

The Affiliated Hospital of Kunming University of Science and Technology, No. 157 Jinbi Road, Kunming City, Yunnan Province, 650500, China.

出版信息

BMC Surg. 2024 Oct 12;24(1):305. doi: 10.1186/s12893-024-02621-x.

DOI:10.1186/s12893-024-02621-x

PMID:39396012

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11470697/

Abstract

BACKGROUND

Acute hepatic dysfunction (AHD) is a common postoperative complication in patients with acute type A aortic dissection. The aim of this study was to identify risk factors for acute hepatic dysfunction after surgery for acute type A aortic dissection.

METHODS

We performed a retrospective study from March 1, 2019, to February 28, 2021. The primary endpoints of this study were morbidity due to AHD and risk factors for incidence. Univariate analysis and multivariate logistic regression analysis were used to analyse the related factors, and receiver operating characteristic (ROC) curves were plotted to evaluate their predictive value.

RESULTS

Among 147 patients, 29 (19.73%) developed postoperative acute hepatic dysfunction, and 9 (6.12%) died. Univariate analysis revealed that the ALT (P = 0.042), Cr (P < 0.001), and BUN (P = 0.008) levels were significantly different between the two groups. Multivariate logistic regression analysis revealed that Cr (OR = 1.013, 95% CI = 1.003-1.023, P = 0.008) was an independent risk factor for postoperative hepatic dysfunction in overweight (BMI > 24) patients with ATAAD. The area under the ROC curve (AUC) for Cr was 0.745 > 0.7, indicating good predictive value.

CONCLUSION

A high Cr concentration is an independent risk factor for postoperative AHD in overweight (BMI > 24) patients with ATAAD.

摘要

背景

急性肝功能障碍（AHD）是急性 A 型主动脉夹层患者术后常见的并发症。本研究旨在确定急性 A 型主动脉夹层术后发生急性肝功能障碍的危险因素。

方法

我们进行了一项回顾性研究，时间为 2019 年 3 月 1 日至 2021 年 2 月 28 日。本研究的主要终点是 AHD 引起的发病率和发病的危险因素。采用单因素分析和多因素逻辑回归分析相关因素，并绘制受试者工作特征（ROC）曲线评估其预测价值。

结果

在 147 例患者中，29 例（19.73%）术后发生急性肝功能障碍，9 例（6.12%）死亡。单因素分析显示，两组间 ALT（P=0.042）、Cr（P<0.001）和 BUN（P=0.008）水平差异有统计学意义。多因素逻辑回归分析显示，Cr（OR=1.013，95%CI=1.003-1.023，P=0.008）是超重（BMI>24）ATAAD 患者术后肝功能障碍的独立危险因素。Cr 的 ROC 曲线下面积（AUC）为 0.745>0.7，表明具有良好的预测价值。