ANALYSIS OF THE PERIOPERATIVE RISK FACTORS IN THE REPAIR OF ACUTE TYPE A AORTIC DISSECTION

Abstract

Background: Acute type A dissection is associated with postoperative complications and a high mortality rate. This study was performed to determine the perioperative risk factors leading to hospital mortality in patients with acute type A aortic dissection. Methods: Fifty patients with acute type A aortic dissection treated surgically were enrolled in this study. 47 perioperative factors were used in statistical analysis for prediction of mortality. Risk factors for hospital death were investigated with univariate and all possible regression analysis tests. Results: The in-hospital mortality rate including operative death was 18 % (9 of 50 patients). Univariate analysis revealed 7 risk factors to be statistically significant predictors of hospital death: aortic incompetence, cardiogenic shock, cardiopulmonary resuscitation, aortic rupture, bypass time, peripheral ischemia and permanent neurologic dysfunction. All possible regression analysis confirmed the univariate analysis results. Postoperative complications were linked to some perioperative risk factors. Conclusions: Perioperative risk factors for death after the operation for acute type A aortic dissection were identified. These findings should contribute to estimation of operative risks in individual patients.