Factors of Prolonged Intensive Care Unit Stay After Surgery in Patients with Type A Acute Aortic Dissection

Khan, Mohammed Firoj; Fa, Xian en; Yu, Hai bin

doi:10.4172/0974-8369.1000367

Cited by 2 publications

(1 citation statement)

References 32 publications

(28 reference statements)

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“…Malperfusion is recognized to occur in a signi cant portion of ATAAD cases, affecting approximately 20-30% of patients 9 . Consequently, the mortality rate for individuals experiencing this complication varies signi cantly, falling within the range of 17-44% 10 .…”

Section: Discussionmentioning

confidence: 99%

Assessing GERAADA Score Mortality Predictions in Type A Aortic Dissection Patients

Nampoukime,

Monteiro,

et al. 2024

Preprint

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Objective: This study seeks to assess the predictive precision of the GERAADA score for 30-day mortality in patients with Type A aortic dissection. Methods: A retrospective study analyzed data from 382 survivors and 90 non-survivors, examining demographic, clinical, and surgical variables. GERAADA scores were calculated by a blinded cardiac surgeon using a web-based application. Results: The overall mortality is 19.06% and 18.18% for GERAADA prediction. The presence of malperfusion in more than two organs emerged as a significant risk factor for hospital mortality p=0.028. Longer surgery times were significantly associated with elevated mortality p=0.002. Moreover, postoperative ECMO, CPR, and IABP were significantly linked to increased mortality rates. Additionally, ICU stay duration, lung infection, MODS, and respiratory failure p<0.05 independently posed as risk factors for hospital mortality. Patients with Hemiparesis and peripheral malperfusion experienced no deaths, as predicted by GERAADA score. Additionally, patients with a dissection tear located at the root of the aorta exhibited a lower mortality rate of 7.14%, contrasting the higher 19.87% GERAADA prediction. Conclusion: GERAADA predictions were mostly accurate, but exceptions occurred with inotrope use, hemiparesis, peripheral malperfusion, and aortic dissection at the root. We suggest enhancing the GERAADA score by incorporating intraoperative and postoperative factors.

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Section: Discussionmentioning

confidence: 99%

Assessing GERAADA Score Mortality Predictions in Type A Aortic Dissection Patients

Nampoukime,

Monteiro,

et al. 2024

Preprint

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Post-operative uric acid: a predictor for 30-days mortality of acute type A aortic dissection repair

et al. 2022

BMC Cardiovasc Disord

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Background: Hyperuricemia is associated with aortic dissection and cardiovascular diseases. The implication of high serum uric acid (UA) level after acute aortic dissection repair remains unknown. The aim of this study is to explore the role of peri-operative serum UA level in predicting 30-days mortality with acute type A aortic dissection (AAAD) patients, who underwent surgery.Methods: This study retrospectively enrolled 209 consecutive patients with AAAD, who underwent surgery in Xiangya Hospital from 2017 to 2020. Post-operative laboratory examinations were measured within 24 h after surgery. Univariate analysis and logistic regression analysis were used for predictor finding.Results: 209 consecutive AAAD patients were included, 14.3% (n = 30) were dead within 30 days after surgery. By univariate analysis, we found AAAD repair patients with 30-days mortality had a higher prevalence of cerebral malperfusion, lower pre-operative fibrinogen, longer cardiopulmonary bypass and aortic crossclamp time, and higher postoperative day 1 (POD1) creatinine and urea levels. Both pre-operative (433.80 ± 152.59 vs. 373.46 ± 108.31 mmol/L, p = 0.038) and POD1 (559.78 ± 162.23 vs. 391.29 ± 145.19 mmol/L, p < 0.001) UA level were higher in mortality group than in survival group. In regression model, only cerebral malperfusion (OR, 7.938, 95% CI 1.252-50.323; p = 0.028) and POD1 UA level (OR, 2.562; 95% CI 1.635-4.014; p < 0.001) were independent predictors of 30-days mortality in AAAD repair patients. According to the ROC curve, the POD1 UA level provided positive value for 30-days mortality in AAAD repair patients with 0.799 areas under the curve. The optimum cutoff value selected by ROC curve was 500.15 mmol/L, with a sensitivity of 65% and a specificity of 86%. Conclusion:Pre-and post-operative hyperuricemia are potentially associated with worsened outcomes in AAAD surgery patients. The POD1 UA level has a predictive role in 30-days mortality in AAAD repair patients.

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Factors of Prolonged Intensive Care Unit Stay After Surgery in Patients with Type A Acute Aortic Dissection

Cited by 2 publications

References 32 publications

Assessing GERAADA Score Mortality Predictions in Type A Aortic Dissection Patients

Assessing GERAADA Score Mortality Predictions in Type A Aortic Dissection Patients

Post-operative uric acid: a predictor for 30-days mortality of acute type A aortic dissection repair

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