Universität zu Köln

Merkle, Julia, Sabashnikov, Anton, Liebig, Lisa, Weber, Carolyn, Eghbalzadeh, Kaveh, Liakopoulos, Oliver, Zeriouh, Mohamed, Kuhn-Regnier, Ferdinand and Wahlers, Thorsten (2019). Factors predictive for early and late mortality after surgical repair for Stanford A acute aortic dissection. Perfusion-UK, 34 (5). S. 375 - 384. LONDON: SAGE PUBLICATIONS LTD. ISSN 1477-111X

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Abstract

Objectives: The aim of this study was to evaluate independent risk factors predictive for mortality of patients with Stanford A acute aortic dissection. Methods: From January 2006 to March 2015, a total of 240 consecutive patients diagnosed with acute Stanford A acute aortic dissection underwent surgical aortic repair in our center. After analysis of pre- and perioperative variables, univariate logistic and multivariate logistic regression analyses were performed for mortality of patients. Subsequently, Kaplan-Meier estimation analysis of short- and long-term survival of these variables was carried out. Results: Primary entry tear in descending aorta (odds ratio = 4.71, p = 0.021), preoperative international normalized ratio higher than 1.2 (odds ratio = 7.36, p = 0.001), additional coronary artery bypass grafting (odds ratio = 3.39, p = 0.003), cannulation in ascending aorta (odds ratio = 3.22, p = 0.005), preoperative neurological coma (odds ratio = 3.30, p = 0.003), and reduced perfusion (odds ratio = 2.91, p = 0.006) as well as prolonged reperfusion time (odds ratio = 3.36, p = 0.002) showed to be independent predictors for early mortality as well as for late mortality (hazard ratio of all variables p < 0.05). Kaplan-Meier survival estimation analysis with up to 9-year-follow-up in terms of these risk factors showed significantly poorer short- and long-term survival (log-rank and Breslow test all p < 0.05). Conclusion: Our study revealed that early and late mortality of patients with Stanford A acute aortic dissection surgery was significantly influenced by preoperative and perioperative variables as independent predictors especially of variables displaying coronary, cerebral, and visceral malperfusion. Also, short- and long-term survival of patients was significantly poorer in terms of these risk factors.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Merkle, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabashnikov, Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Liebig, Lisa UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Carolyn UNSPECIFIED UNSPECIFIED UNSPECIFIED Eghbalzadeh, Kaveh UNSPECIFIED UNSPECIFIED UNSPECIFIED Liakopoulos, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED Zeriouh, Mohamed UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn-Regnier, Ferdinand UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-136823
DOI:	10.1177/0267659118822947
Journal or Publication Title:	Perfusion-UK
Volume:	34
Number:	5
Page Range:	S. 375 - 384
Date:	2019
Publisher:	SAGE PUBLICATIONS LTD
Place of Publication:	LONDON
ISSN:	1477-111X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LONG-TERM OUTCOMES; RISK-FACTORS; CANNULATION Multiple languages Cardiac & Cardiovascular Systems; Peripheral Vascular Disease Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13682