Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Tamura, Yudai, Tamura, Yuichi, Kametani, Motoko, Minami, Yoshiaki, Nakayama, Tomoko, Takagi, Daisuke, Unoki, Takashi, Yamamuro, Megumi, Kawamura, Akio, Sakamoto, Tomohiro, Sawamura, Tadashi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
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
_version_ 1784609675578179584
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
work_keys_str_mv AT tamurayudai predictorsofhypoxemiaintypebacuteaorticsyndromearetrospectivestudy
AT tamurayuichi predictorsofhypoxemiaintypebacuteaorticsyndromearetrospectivestudy
AT kametanimotoko predictorsofhypoxemiaintypebacuteaorticsyndromearetrospectivestudy
AT minamiyoshiaki predictorsofhypoxemiaintypebacuteaorticsyndromearetrospectivestudy
AT nakayamatomoko predictorsofhypoxemiaintypebacuteaorticsyndromearetrospectivestudy
AT takagidaisuke predictorsofhypoxemiaintypebacuteaorticsyndromearetrospectivestudy
AT unokitakashi predictorsofhypoxemiaintypebacuteaorticsyndromearetrospectivestudy
AT yamamuromegumi predictorsofhypoxemiaintypebacuteaorticsyndromearetrospectivestudy
AT kawamuraakio predictorsofhypoxemiaintypebacuteaorticsyndromearetrospectivestudy
AT sakamototomohiro predictorsofhypoxemiaintypebacuteaorticsyndromearetrospectivestudy
AT sawamuratadashi predictorsofhypoxemiaintypebacuteaorticsyndromearetrospectivestudy