Associated Risk Factors Of In-hospital Death Analysis Of 224 Patients With Aortic Dissection

Objective: To determine associated risk factors of in-hospital death of patients with aortic dissection(AD).Methods: 224 patients with AD from our hospital cardiac care unite were analyzed from January 2010 to January 2012.According to death or not death,patients were divided into death group and no death group.Use Logistic regression to analysis risk factors of in-hospital death.The hemodynamics of two typical patients was analyzed by computational fluid dynamics(CFD).Results: There were significant differences in drinking,hypertension history,operation distribution and diastolic blood pressure between the two groups(P<0.05).In the analysis of the imaging features of patients with aortic dissection,the difference between the two groups was statistically significant(P<0.05)in the arteries,renal cysts,fatty liver and cholecystolithiasis,and the death group had more important arterial branches.Diastolic blood pressure,hemoglobin,hematocrit,total protein,globulin,percentage of eosinophils,basophil percentage,eosinophil count,basophil count,hemoglobin,platelet count,platelet count,Lipoprotein AI,prothrombin time,PT activity,fibrinogen,ascending aortic diameter were significantly difference in death group than those of no death group(P<0.05).Logistic regression analysis showed that the basophil count(OR=0.001,95%CI=0.001~0.485,P<0.05)and hemoglobin(OR=0.965,95%CI=0.932~0.999,P<0.05)were the protection factors,ascending aortic diameter(OR=1.109,95%CI=1.010 ~ 1.218,P<0.05)was the independent risk factor of in-hospital death of patients with AD.CFD analysis showed that the maximal wall pressure and the maximum shear stress were greater than those of non-dead patients during the majority of cardiac cycle,and the trend was large and fast.In the second half of the cardiac cycle,arterial close to no blood flow.Conclusion: Ascending aortic diameter was the independent risk factor of in-hospital death of patients with AD,basophil count and hemoglobin were the protection factors.AD patients with hospital death and hemodynamics were significantly related to CFD analysis can be a certain extent,to simulate the true blood flow in patients with the state,so as to predict the possibility of death in patients with hospital.