Analysis Of Risk Factors Of Acute Aortic Dissection Complicated With Acute Lung Injury And The Establishment Of Predictive Rating Scale

Objective: To establish the rating scale of AAD complicated with ALI by analyzin-g the risk factors of AAD complicated with ALI.Method: The clinical data of 143 patients with AAD in the First Affiliated Hospital of Xinjiang Medical University from January 2014 to December 2015 were retrospectively analyzed.They were d-ivided into ALI group and non ALI group according to whether or not it occurred.Single factor analysis was performed to identify possible risk factors.Statistically r-elevant factors were analyzed to determine the optimal critical value and predictive value of ALI by drawing the receiver operating characteristic curve(ROC curve).A-ccording to the optimal critical value,the related continuous variables were transfor-med into two categorical variables,and the multivariate Logistic regression analysis was performed.According to the OR value of each risk factor,the independent risk f-actors were assigned to establish the rating scale.Results:(1)The incidence of AAD complicated with ALI was 44.76%.(2)BMI,WBC and CRP at admission in the A-LI group were higher than those in the non-ALI group,and the difference was stat-istically significant between the two groups(P<0.05).ALI group compared with no n-ALI group,patients of ALI group at admission with pleural effusion easily,and the difference was statistically significant between the two groups(P<0.05).(3)By drawi-ng the ROC curve,the optimal critical value of BMI to predict the incidence of AAD complicated with ALI was 25.65kg/m2(sensitivity:87.5%,specificity:40.5%).Th-e optimal critical value of WBC to predict the incidence of AAD complicated wit-h ALI was 15.00×109/L(sensitivity:59.4%,specificity:81.0%).The optimal critical valu-e of CRP to predict the incidence of AAD complicated with ALI was 15.81mg/L(sensitivity:51.6%,specificity:75.6%).The sensitivity of pleural effusion at admission t-o predict the incidence of AAD complicated with ALI was 57.8%,and the specific-ity was 65.8%.(4)Two groups of patients were performed by multivariate Logistic regression analysis,which showed that WBC?15.00×109/L(OR=7.143,95%CI 2.972-17.16),CRP?15.81mg/L(OR=2.696,95%CI 1.156-6.284),BMI?25.65kg/m2(OR=5.892,95%C I 2.117-16.396)and pleural effusion at admission(OR=4.365,95%CI 1.849-10.300)are the independent risk factors.(5)Patients with AAD were divided into three groups according to the scores of independent risk factors in the risk rating scale:low-risk group(score 0-3),average-risk group(score 4-6)and high-risk group(score 7-9).The incidence rate of ALI in low-risk group was 12.5%,the incidence rate of ALI in t-he average risk group was about 53.7%,and the incidence rate of ALI in high-ris k group was about 84.8%.Conclusion: By analyzing the risk factors of AAD comp-licated with ALI,we found that BMI,WBC,CRP and pleural effusion at admission were the independent risk factors of AAD complicated with ALI.The rating scale c-an assess the occurrence risk of ALI of patients with AAD predictably.The risk as-sessment tool may help the hierarchical management of patients with AAD.