Hypoxemia In Acute Stanford Type A Aortic Dissection-Risk Factors Analysis

Objective The article dedicated to screening risk factors of hypoxemia in patients with acute Stanford type A aortic dissection.Methods A retrospective analysis of patients with acute Stanford type A aortic dissection, from Jan 2013 to Jan 2014 in Nanjing Drum Tower Hospital, including gender,age, body mass index, associating with hypertension, smoking history, as well as the laboratory examination:count of white blood cell, neutrophile granulocyte, hemoglobin, C reactive protein(CRP), PT, lactic acid and some intraoperative and postoperative data as volume of blood transfusion etc. Hypoxemia is defined as the oxygenation index less than 300(Pa02/Fi02<300). Student’s t-test, chi-square test, Mann-Whitney U test, univariate analysis and multivariate Logistic regression, ROC curves were used to analyze the association between patients’ clinical data and hypoxemia.Results Forty-five patients were enrolled in this study. In these selected patients,37 cases were male(82%)and 8 cases were female(18%), whose average age was 49.6±13.0 years old, while male and female patients with an average age of no difference(49.05±12.2years old VS 52.1 ±16.7years old, P>0.05). The average body mass index was 25.3±2.7(kg/m2).31cases (69 %)with hypertension.13 cases(29%) with smoking history.The preoperative meanoxygenation index was284.6±91.1,among which there were 24 cases (53.3%) with hypoxemia.Oxygenation index of preoperative hypoxemia group was 220.1±61.7, oxygenation index of preoperative non-hypoxic group the was358.2±56.7 (P<0.05). The postoperative meanoxygenation index was209.2±87.1,among which there were 38 cases (84%) with hypoxemia.Oxygenation index of postoperative hypoxemia group was 182.3±63.9, oxygenation index of postoperative non-hypoxic group the was355.1±31.5(P<0.05). Logistic regression analysis of independent risk factors for preoperative hypoxemia was C reactive protein level(OR:1.176,95%CI:1.025-1.348).Logistic regression analysis of independent risk factors for postoperative hypoxemia include:volume of blood transfusion (OR:1.005,95%CI:1.001-1.010)Conclusions 1.Hypoxemia has a high incidence in acute Stanford type A aortic dissection.2.C reactive protein level was an independent risk factor for preoperative hypoxemia in patients with acute Stanford type A aortic dissection.3. Volume of blood transfusion was an independent risk factor for postoperative hypoxemia in patients with acute Stanford type A aortic dissection.4.Body mass index may be associated with preoperative hypoxemia in acute Stanford type A aortic dissection.5.The preoperative oxygenation index may be associated with postoperative hypoxemia in acute Stanford type A aortic dissection.