Risk Factors For Perioperative Period Death With Acute Stanford Type A Aortic Dissection

Objective: To investigate the risk factors of early in-hospital death in patients with acute Stanford type A aortic dissection and emergency surgical treatment.Methods: We retrospectively analyzed the clinical data of 189 patients with acute Stanford type A aortic dissection who underwent surgery in the first affiliated hospital of Xinjiang medical university between January 2017 to January 2020.There were 160 males(84.7%)and 29 females(15.3%)with an average age of 46.35±9.17 years.All patients underwent surgical treatment within 24 hours.The patients were divided into survival group(n=160)and death group(n=29)according to their outcome(survival or death)during hospitalization in our hospital.Perioperative clinical data were analyzed and compared between the two groups.Results:The overall in-hospital mortality is 15.3%(29/189).There was significant difference between the two groups in white blood cell count,blood glucose,Aspartate aminotransferase(AST),bilirubin,creatinine,operative method,Operation time,aorticoc clusion time and cardiopulmonary bypass time(P<0.05).Multivariate regression nident ified WBC(OR=1.142,95%CI:1.008～1.293),bilirubin(OR=0.906,95%CI:0.833～0.985),cr-eatinine(OR=1.009,95%CI:1.000～1.017),cardiopulmonary bypass time(OR=1.013,95%CI:1.003～1.024)as independent predictors of postoperative risk factors for patients undergoing acute Stanford type A aortic dissection surgery(P<0.05).Conclusions: Our study demonstrated that WBC,bilirubin,creatinine and cardiopulmonary bypass time were independent risk factors of in-hospital death after acute Stanford type A aortic dissection surgery.