Background Patients with acute type A aortic dissection have a high incidence of postoperative cerebral complication. Better understanding of the risk factors could help to optimize prevention and treatment strategies...Background Patients with acute type A aortic dissection have a high incidence of postoperative cerebral complication. Better understanding of the risk factors could help to optimize prevention and treatment strategies. Method A total of 298 patients of acute type A aortic dissection operated in Guangdong Cardiac Institution from 2010.10 to 2014.12 were included, 253 of them were male and the other 45 were female. Their average age was 45.8__. 12.2y. All the patients were divided into cerebral complication and no cerebral complication groups. Data collectedfrom both groups were analyzed by univariate and multivariate analyses to identify the indepen- dent risk factors of postoperative cerebral complication. Result The incidence of postoperative cerebral compli- cation was 37.9% （113/298）. Among 113 patients, temporary nerve damage （TND） group and permanent nerve damage （PND） accounted for 93 cases（31.2%） and 20 cases （6.7%） respectively. Logistic Regress multivariate analysis showed that history of hypertension （OR=2.560, 95%CI, 1.397-4.692, P〈0.01）, total arch replacement （OR=2.315, 95%CI, 1.386-3.869, P〈0.01）, time of aortic arrest （OR=1.008, 95%CI, 1.004-1.012, P〈0.01） and postoperative hypoxemia （OR=1.858, 95%CI, 1.122-3.078, P〈0.05） were the independent risk factors of the post- operative cerebral complication in patients with acute type A aortic dissection. Conclusion Incidence of postop- erative cerebral complication is high in the acute type A aortic dissection patients itsmajor risk factors are hypertension history, total arch replacement, and long duration of aortic arrest or hypoxemia.展开更多
基金supported by Science and Technology Program of Guangzhou(No.2014y2-00052)Guangdong medical science and Technology Research Fund(No.201512513201245)
文摘Background Patients with acute type A aortic dissection have a high incidence of postoperative cerebral complication. Better understanding of the risk factors could help to optimize prevention and treatment strategies. Method A total of 298 patients of acute type A aortic dissection operated in Guangdong Cardiac Institution from 2010.10 to 2014.12 were included, 253 of them were male and the other 45 were female. Their average age was 45.8__. 12.2y. All the patients were divided into cerebral complication and no cerebral complication groups. Data collectedfrom both groups were analyzed by univariate and multivariate analyses to identify the indepen- dent risk factors of postoperative cerebral complication. Result The incidence of postoperative cerebral compli- cation was 37.9% （113/298）. Among 113 patients, temporary nerve damage （TND） group and permanent nerve damage （PND） accounted for 93 cases（31.2%） and 20 cases （6.7%） respectively. Logistic Regress multivariate analysis showed that history of hypertension （OR=2.560, 95%CI, 1.397-4.692, P〈0.01）, total arch replacement （OR=2.315, 95%CI, 1.386-3.869, P〈0.01）, time of aortic arrest （OR=1.008, 95%CI, 1.004-1.012, P〈0.01） and postoperative hypoxemia （OR=1.858, 95%CI, 1.122-3.078, P〈0.05） were the independent risk factors of the post- operative cerebral complication in patients with acute type A aortic dissection. Conclusion Incidence of postop- erative cerebral complication is high in the acute type A aortic dissection patients itsmajor risk factors are hypertension history, total arch replacement, and long duration of aortic arrest or hypoxemia.
