Risk factors for thepostoperative cerebral complicationin patients with acute type A aortic dissection

摘要

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 independent risk factors of postoperative cerebral complication. Result The incidence of postoperative cerebral complication 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 postoperative cerebral complication in patients with acute type A aortic dissection. Conclusion Incidence of postoperative 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.