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Hepatic dysfunction and adverse outcomes after total arch repair of acute type a aortic dissection: application of the MELD-XI score
BACKGROUND: This study was aimed to investigate the incidence and outcomes of patients with postoperative hepatic dysfunction (PHD) after total arch repair of acute type A aortic dissection, and further explore the risk factors for severe adverse outcomes. METHODS: The clinical data of 227 patients...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9673427/ https://www.ncbi.nlm.nih.gov/pubmed/36401191 http://dx.doi.org/10.1186/s12872-022-02934-w |
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author | Lin, Xinfan Xie, Linfeng Jiang, Debin Wu, Qingsong He, Jian Chen, Liangwan |
author_facet | Lin, Xinfan Xie, Linfeng Jiang, Debin Wu, Qingsong He, Jian Chen, Liangwan |
author_sort | Lin, Xinfan |
collection | PubMed |
description | BACKGROUND: This study was aimed to investigate the incidence and outcomes of patients with postoperative hepatic dysfunction (PHD) after total arch repair of acute type A aortic dissection, and further explore the risk factors for severe adverse outcomes. METHODS: The clinical data of 227 patients with AAAD treated by modified triple-branched stent graft implantation from January 2020 to January 2021 were collected retrospectively. Including preoperative, surgical and postoperative data. Logistics regression was used to determine the independent risk factors of severe adverse outcomes in postoperative HD patients. RESULTS: In the early stage after operation, a total of 153 patients were complicated with PHD, accounting for 67.4%. The incidence of severe adverse outcomes in patients with PHD was 43.1%. We found that preoperative moderate/severe pericardial effusion [odds ratio (OR): 11.645, 95% confidence interval (CI): 1.144, 143.617, P = 0.045], preoperative imaging data suggest the celiac trunk involvement [OR: 6.136, 95% CI 1.019, 36.930, P = 0.048], CPB time > 180 min [OR: 4.855, 95% CI 1.218, 15.761, P = 0.034], decreased early postoperative serum albumin [OR: 0.935, 95% CI 0.856, 0.985, P = 0.026] were independent risk factors for severe adverse outcomes in patients with PHD. CONCLUSIONS: PHD was associated with increased early mortality and morbidity. Preoperative moderate/severe pericardial effusion, preoperative celiac trunk involvement, cardiopulmonary bypass (CPB) time > 180 min and decreased early postoperative serum albumin were identified as independent risk factors for severe adverse outcomes in patients with PHD. |
format | Online Article Text |
id | pubmed-9673427 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-96734272022-11-19 Hepatic dysfunction and adverse outcomes after total arch repair of acute type a aortic dissection: application of the MELD-XI score Lin, Xinfan Xie, Linfeng Jiang, Debin Wu, Qingsong He, Jian Chen, Liangwan BMC Cardiovasc Disord Research BACKGROUND: This study was aimed to investigate the incidence and outcomes of patients with postoperative hepatic dysfunction (PHD) after total arch repair of acute type A aortic dissection, and further explore the risk factors for severe adverse outcomes. METHODS: The clinical data of 227 patients with AAAD treated by modified triple-branched stent graft implantation from January 2020 to January 2021 were collected retrospectively. Including preoperative, surgical and postoperative data. Logistics regression was used to determine the independent risk factors of severe adverse outcomes in postoperative HD patients. RESULTS: In the early stage after operation, a total of 153 patients were complicated with PHD, accounting for 67.4%. The incidence of severe adverse outcomes in patients with PHD was 43.1%. We found that preoperative moderate/severe pericardial effusion [odds ratio (OR): 11.645, 95% confidence interval (CI): 1.144, 143.617, P = 0.045], preoperative imaging data suggest the celiac trunk involvement [OR: 6.136, 95% CI 1.019, 36.930, P = 0.048], CPB time > 180 min [OR: 4.855, 95% CI 1.218, 15.761, P = 0.034], decreased early postoperative serum albumin [OR: 0.935, 95% CI 0.856, 0.985, P = 0.026] were independent risk factors for severe adverse outcomes in patients with PHD. CONCLUSIONS: PHD was associated with increased early mortality and morbidity. Preoperative moderate/severe pericardial effusion, preoperative celiac trunk involvement, cardiopulmonary bypass (CPB) time > 180 min and decreased early postoperative serum albumin were identified as independent risk factors for severe adverse outcomes in patients with PHD. BioMed Central 2022-11-18 /pmc/articles/PMC9673427/ /pubmed/36401191 http://dx.doi.org/10.1186/s12872-022-02934-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis 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/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Lin, Xinfan Xie, Linfeng Jiang, Debin Wu, Qingsong He, Jian Chen, Liangwan Hepatic dysfunction and adverse outcomes after total arch repair of acute type a aortic dissection: application of the MELD-XI score |
title | Hepatic dysfunction and adverse outcomes after total arch repair of acute type a aortic dissection: application of the MELD-XI score |
title_full | Hepatic dysfunction and adverse outcomes after total arch repair of acute type a aortic dissection: application of the MELD-XI score |
title_fullStr | Hepatic dysfunction and adverse outcomes after total arch repair of acute type a aortic dissection: application of the MELD-XI score |
title_full_unstemmed | Hepatic dysfunction and adverse outcomes after total arch repair of acute type a aortic dissection: application of the MELD-XI score |
title_short | Hepatic dysfunction and adverse outcomes after total arch repair of acute type a aortic dissection: application of the MELD-XI score |
title_sort | hepatic dysfunction and adverse outcomes after total arch repair of acute type a aortic dissection: application of the meld-xi score |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9673427/ https://www.ncbi.nlm.nih.gov/pubmed/36401191 http://dx.doi.org/10.1186/s12872-022-02934-w |
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