Chen Pengfei, Li Haochao, Liu Chenyu, Chen Mingjian, Zhao Diming, Chen Liang, Qian Xiangyang, Pu Jundong, Chen Zujun, Wang Yuetang, Wang Liqing
Cardiovascular Surgery Department, Fuwai Hospital, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovescular Diseases, Beijing, China.
Intensive Care Unit, Dali Bai Autonomous Prefecture People's Hospital, Dali, Yunnan, China.
BMC Surg. 2025 Jul 28;25(1):318. doi: 10.1186/s12893-025-03062-w.
The objective of this study was to identify the perioperative risk factors associated with postoperative pulmonary complications (PPCs) following emergency surgery for Acute Type A Aortic Dissection (ATAAD) and to evaluate the impact of these complications on short- and long-term patient outcomes.
A retrospective observational analysis was conducted on 750 adult patients who underwent emergency surgery for ATAAD between January 2017 and December 2019.
The overall in-hospital mortality was 5.7%. Among 750 patients, 91 patients(12.1%) developed PPCs. Multivariable logistic regression analysis indicated that smoking(OR = 2.212, 95%CI: 1.361-3.595, P = 0.001), previous cardiac surgery(OR = 2.818, 95%CI: 1.259-6.310, P = 0.012), CPB time(OR = 1.003, 95%CI: 1.000-1.006, P = 0.047), and red blood cell transfusion(OR = 1.091, 95%CI: 1.059-1.124, P < 0.001) were associated with an increased risk of developing PPCs. Patients who developed PPCs had a higher 30-day mortality rate (P < 0.001), longer lengths of stay in the ICU and hospital(P < 0.001), increased healthcare costs(P < 0.001), and lower long-term survival rates(P = 0.005).
The incidence of PPCs is high in patients undergoing cardiac surgery for aortic dissection, adversely affecting their prognosis. This study identified four key risk factors associated with the development of PPCs.
本研究的目的是确定急性A型主动脉夹层（ATAAD）急诊手术后与术后肺部并发症（PPCs）相关的围手术期危险因素，并评估这些并发症对患者短期和长期预后的影响。
对2017年1月至2019年12月期间接受ATAAD急诊手术的750例成年患者进行回顾性观察分析。
总体住院死亡率为5.7%。在750例患者中，91例（12.1%）发生了PPCs。多变量逻辑回归分析表明，吸烟（OR = 2.212，95%CI：1.361 - 3.595，P = 0.001）、既往心脏手术（OR = 2.818，95%CI：1.259 - 6.310，P = 0.012）、体外循环时间（OR = 1.003，95%CI：1.000 - 1.006，P = 0.047）和红细胞输注（OR = 1.091，95%CI：1.059 - 1.124，P < 0.001）与发生PPCs的风险增加相关。发生PPCs的患者30天死亡率更高（P < 0.001），在重症监护病房和医院的住院时间更长（P < 0.001），医疗费用增加（P < 0.001），长期生存率更低（P = 0.005）。
主动脉夹层心脏手术患者PPCs的发生率较高，对其预后产生不利影响。本研究确定了与PPCs发生相关的四个关键危险因素。
