Factors Related to Hospitalisation-Associated Disability in Patients after Surgery for Acute Type A Aortic Dissection: A Retrospective Study

Abstract

The in-hospital mortality rate among patients after surgery for acute type A aortic dissection (ATAAD) has improved chronologically. However, the relationship between the incidence of hospitalisation-associated disability (HAD) and acute cardiac rehabilitation in patients after surgery for ATAAD has not been reported. Therefore, this study evaluated factors related to HAD in patients after surgery for ATAAD. This single-centre retrospective observational study included 483 patients who required emergency surgery for ATAAD. HAD occurred in 104 (21.5%) patients following cardiovascular surgery. Factors associated with HAD were age (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.02–1.09; p = 0.001), noninvasive positive pressure ventilation (NPPV; OR, 2.15; 95% CI, 1.10–4.19; p = 0.025), postoperative delirium (OR, 2.93; 95% CI, 1.60–5.37; p = 0.001), and timing of walking onset (OR, 1.29; 95% CI, 1.07–1.56; p = 0.008). Furthermore, a late walking onset was associated with a higher risk of developing HAD and more severe functional decline. Early rehabilitation based on appropriate criteria has possibility of preventing HAD.

Systematic review and meta-analysis of the risk factors for postoperative delirium in patients with acute type A aortic dissection

“…Acute type A aortic dissection is a critical illness characterized by disseminated intravascular coagulation that can accumulate in multiple viscera (6,20,21). Although the level of surgical treatment has been improved in recent years and the mortality rate has been reduced, postoperative complications are still an important factor leading to the death of patients (9,22). As a common complication after cardiac surgery, postoperative delirium has a high incidence rate.…”

How to help aortic dissection survivors with recovery?: A health promotion program based on the comprehensive theory of health behavior change and literature review

“…[4] However, AD survivors still face many challenges, such as postoperative complications, impairment of physical function, decreased quality of life, and psychological trauma. [5][6][7][8] Therefore, the health promotion of AD is one of the important means to help them recover from the disease.…”