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Predictors of hypoxemia in type-B acute aortic syndrome: a retrospective study
Acute aortic syndrome (AAS) can be life-threatening owing to a variety of complications, and it is managed in the intensive care unit (ICU). Although Stanford type-B AAS may involve hypoxemia, its predictors are not yet clearly understood. We studied clinical factors and imaging parameters for predi...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8642401/ https://www.ncbi.nlm.nih.gov/pubmed/34862435 http://dx.doi.org/10.1038/s41598-021-02886-9 |
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author | Tamura, Yudai Tamura, Yuichi Kametani, Motoko Minami, Yoshiaki Nakayama, Tomoko Takagi, Daisuke Unoki, Takashi Yamamuro, Megumi Kawamura, Akio Sakamoto, Tomohiro Sawamura, Tadashi |
author_facet | Tamura, Yudai Tamura, Yuichi Kametani, Motoko Minami, Yoshiaki Nakayama, Tomoko Takagi, Daisuke Unoki, Takashi Yamamuro, Megumi Kawamura, Akio Sakamoto, Tomohiro Sawamura, Tadashi |
author_sort | Tamura, Yudai |
collection | PubMed |
description | Acute aortic syndrome (AAS) can be life-threatening owing to a variety of complications, and it is managed in the intensive care unit (ICU). Although Stanford type-B AAS may involve hypoxemia, its predictors are not yet clearly understood. We studied clinical factors and imaging parameters for predicting hypoxemia after the onset of type-B AAS. We retrospectively analyzed patients diagnosed with type-B AAS in our hospital between January 2012 and April 2020. We defined hypoxemia as PaO(2)/FiO(2) ≤ 200 within 7 days after AAS onset and used logistic regression analysis to evaluate prognostic factors for hypoxemia. We analyzed 224 consecutive patients (140 males, mean age 70 ± 14 years) from a total cohort of 267 patients. Among these, 53 (23.7%) had hypoxemia. The hypoxemia group had longer ICU and hospital stays compared with the non-hypoxemia group (median 20 vs. 16 days, respectively; p = 0.039 and median 7 vs. 5 days, respectively; p < 0.001). Male sex (odds ratio [OR] 2.87; 95% confidence interval [CI] 1.24–6.63; p = 0.014), obesity (OR 2.36; 95% CI 1.13–4.97; p = 0.023), patent false lumen (OR 2.33; 95% CI 1.09–4.99; p = 0.029), and high D-dimer level (OR 1.01; 95% CI 1.00–1.02; p = 0.047) were independently associated with hypoxemia by multivariate logistic analysis. This study showed a significant difference in duration of ICU and hospital stays between patients with and without hypoxemia. Furthermore, male sex, obesity, patent false lumen, and high D-dimer level may be significantly associated with hypoxemia in patients with type-B AAS. |
format | Online Article Text |
id | pubmed-8642401 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-86424012021-12-06 Predictors of hypoxemia in type-B acute aortic syndrome: a retrospective study Tamura, Yudai Tamura, Yuichi Kametani, Motoko Minami, Yoshiaki Nakayama, Tomoko Takagi, Daisuke Unoki, Takashi Yamamuro, Megumi Kawamura, Akio Sakamoto, Tomohiro Sawamura, Tadashi Sci Rep Article Acute aortic syndrome (AAS) can be life-threatening owing to a variety of complications, and it is managed in the intensive care unit (ICU). Although Stanford type-B AAS may involve hypoxemia, its predictors are not yet clearly understood. We studied clinical factors and imaging parameters for predicting hypoxemia after the onset of type-B AAS. We retrospectively analyzed patients diagnosed with type-B AAS in our hospital between January 2012 and April 2020. We defined hypoxemia as PaO(2)/FiO(2) ≤ 200 within 7 days after AAS onset and used logistic regression analysis to evaluate prognostic factors for hypoxemia. We analyzed 224 consecutive patients (140 males, mean age 70 ± 14 years) from a total cohort of 267 patients. Among these, 53 (23.7%) had hypoxemia. The hypoxemia group had longer ICU and hospital stays compared with the non-hypoxemia group (median 20 vs. 16 days, respectively; p = 0.039 and median 7 vs. 5 days, respectively; p < 0.001). Male sex (odds ratio [OR] 2.87; 95% confidence interval [CI] 1.24–6.63; p = 0.014), obesity (OR 2.36; 95% CI 1.13–4.97; p = 0.023), patent false lumen (OR 2.33; 95% CI 1.09–4.99; p = 0.029), and high D-dimer level (OR 1.01; 95% CI 1.00–1.02; p = 0.047) were independently associated with hypoxemia by multivariate logistic analysis. This study showed a significant difference in duration of ICU and hospital stays between patients with and without hypoxemia. Furthermore, male sex, obesity, patent false lumen, and high D-dimer level may be significantly associated with hypoxemia in patients with type-B AAS. Nature Publishing Group UK 2021-12-03 /pmc/articles/PMC8642401/ /pubmed/34862435 http://dx.doi.org/10.1038/s41598-021-02886-9 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Tamura, Yudai Tamura, Yuichi Kametani, Motoko Minami, Yoshiaki Nakayama, Tomoko Takagi, Daisuke Unoki, Takashi Yamamuro, Megumi Kawamura, Akio Sakamoto, Tomohiro Sawamura, Tadashi Predictors of hypoxemia in type-B acute aortic syndrome: a retrospective study |
title | Predictors of hypoxemia in type-B acute aortic syndrome: a retrospective study |
title_full | Predictors of hypoxemia in type-B acute aortic syndrome: a retrospective study |
title_fullStr | Predictors of hypoxemia in type-B acute aortic syndrome: a retrospective study |
title_full_unstemmed | Predictors of hypoxemia in type-B acute aortic syndrome: a retrospective study |
title_short | Predictors of hypoxemia in type-B acute aortic syndrome: a retrospective study |
title_sort | predictors of hypoxemia in type-b acute aortic syndrome: a retrospective study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8642401/ https://www.ncbi.nlm.nih.gov/pubmed/34862435 http://dx.doi.org/10.1038/s41598-021-02886-9 |
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