Analysis Of Risk Factors Of Short-Term Hospital Death In Postoperative Patients With Type A Aortic Dissection

ObjectiveThis paper collected Stanford A aortic dissection cases in our hospital,and summarized the related risk factors for short-term hospital deaths after surgery,providing scientific basis for clinical diagnosis and prognosis.MethodsWe retrospectively analyzed the medical records of 85 patients underwent Stanford type A aortic dissection surgery in our hospital from January 2016 to December 2016.According to whether short-term death occurred or not,10 patients were divided into death group(n = 10)and survival group(n = 75),investigating case-related clinical data,collecting relevant factors influencing the possibility of short-term mortality in patients after surgery,and conducting statistical analysis.Related factors include age,gender,diabetes,hypertension,acute onset,history of cardiovascular surgery,white blood cell count,hemoglobin,total bilirubin,direct bilirubin,alanine aminotransferase,aspartate aminotransferase,albumin,serum creatinine,pulmonary infection and left ventricular ejection fraction 19 preoperative factors.Emergency surgery,operation time,Cardiopulmonary Bypass(CPB)time,stop circulation time,blocking time,replacement of aortic valve,coronary artery bypass graft,and surgical approach 8 surgical intraoperative risk factors.Postoperative infusion of filtered leucocytes,plasma volume,platelet volume,drainage tube indwelling time,nasal feeding tube indwelling time,postoperative auxiliary ventilation time,multiple tracheal intubation,tracheotomy,ICU stay time,multiple infusion ICU,intra-aortic balloon counterpulsation and other 19 postoperative risk factors.Using SPSS 21.0 software to import relevant case data,preliminary analysis of relevant factors,screening out statistically significant risk factors.Then it was subjected to binary logistic regression analysis to obtain independent risk factors for in-hospital short-term death after Stanford A aortic dissection and to conduct scientific analysis.ResultsThe preliminary analysis showed that plasma volume,CPB time,operative time,Postoperative assisted ventilation time,and continuous renal replacement therapy were associated with short-term hospital deaths after Stanford type A aortic dissection.The multivariate analysis showed that CPB time and postoperative assisted ventilation time were independent risk factors for short-term hospital death in postoperative patients with Stanford type A aortic dissection.ConclusionCPB time,postoperative assisted ventilation time may be independent risk factors of short-term hospital death in postoperative patients with Stanford type A aortic dissection.Therefore,a reasonable understanding of the time of CPB and postoperative assisted ventilation time can reduce the chance of short-term hospital death in postoperative patients with Stanford type A aortic dissection.