Risk factors for postoperative prolonged ventilation time in acute type a aortic dissection patients received modified aortic root procedure

Abstract

Background: Postoperative prolonged ventilation time (PPVT) is associated with increased mortality in acute type A aortic dissection (ATAAD). The aim of this study is to investigate risk factors for PPVT in ATAAD patients. Methods: We retrospectively collected ATAAD patient data for those who received modified aortic root procedure and extensive arch repair between June 2017 and June 2018 at our institution. Patients were included in PPVT (N = 30) and No-PPVT (N = 72) groups, according to whether postoperative ventilation time > 72 hours. Univariate and multivariate logistic regression analysis were adopted to determine the independent risk factors for PPVT. Results: More female in the PPVT Group (56.67% versus 23.61%, P < .05). Max diameter (MD) of ascending aorta was wider in the PPVT Group (4.71 ± 1.02 versus 4.30 ± 0.61, P < .05). Postoperative data showed a higher in-hospital mortality in the PPVT Group (26.67% versus 5.56%, P < .05). There were more patients in the PPVT Group who experienced postoperative acute renal failure (ARF) (36.67% versus 5.56%, P < .05). Multivariable logistic regression analysis showed female gender, MD of ascending aorta > 4.05 cm, and postoperative ARF were independent risk factors for PPVT with the OR of 3.55 (1.13 - 11.20, P < .05), 2.89 (1.02 - 8.22, P < .05), and 4.31 (1.03 - 18.02, P < .05), respectively. Conclusions: In the present study, we determined female gender, MD of ascending aorta > 4.05 cm, and postoperative ARF within 72 hours were independent risk factors for PPVT in ATAAD patients received modified root procedure and extensive arch repair.