Preoperative risk factors and 180-day postoperative mortality in type a aortic dissection: a cohort study.
- 1Emergency and Trauma Center, The First Affiliated Hospital, Zhejiang University School of Medicine, 1367 Wenyi West Road,Yuhang District, Hangzhou, China.
- 2Emergency and Trauma Center, The First Affiliated Hospital, Zhejiang University School of Medicine, 1367 Wenyi West Road,Yuhang District, Hangzhou, China. [email protected].
Abstract
Objectives
To explore modifiable risk factors associated with 180-day postoperative mortality based on preoperative examinations in patients with type A aortic dissection.Methods
From August 2021 to November 2024,86 patients with TAAD attending the Emergency and Trauma Center of the First Affiliated Hospital,Zhejiang University School of Medicine were included in this study.The primary endpoint was follow-up of patients 180 days after operation.Results
25 (29.07%) of the 86 patients were dead within 180-day, with preoperative cardiac arrest and postoperative multiple organ failure being the primary causes of death. Comparison of baseline data between the survivors and the 180-day postoperative mortality revealed statistically significant differences in gender, age, mean arterial pressure, lactate, hemoglobin, D-dimer, fibrinogen, albumin, ST-T abnormalities, impaired intestinal blood supply, coronary artery bypass graft surgery, and GERAADA score (P < 0.05). By multivariate logistic regression analysis, fibrinogen, albumin, ST-T abnormalities, and impaired intestinal blood supply were risk factors of 180-day postoperative mortality, while gender was a protective parameter of 180-day postoperative mortality.Conclusions
Preoperative risk stratification demonstrates significant predictive value for 180-day postoperative mortality in TAAD patients.Our findings identify a high-risk profile characterized by hypofibrinogenemia,electrocardiographic ST-T abnormalities,and intestinal malperfusion.A multimodal therapeutic approach incorporating aggressive preoperative fibrinogen replacement guided by ROTEM/TEG,consideration of visceral stenting prior to central repair in cases of severe malperfusion,high suspicion for coronary involvement in patients with ST-T abnormalities,may potentially reduce early postoperative mortality in this vulnerable population.
Related
- Preoperative Inflammatory Risk Markers and Postoperative Creatinine and Lactate as Mortality Markers After Surgery for Stanford Type A Acute Aortic Dissection
- Performance and incremental value of preoperative multimodal imaging and perioperative clinical characteristics in predicting postoperative major adverse events in type A aortic dissection
- Clinical Risk Factors and Inflammatory Markers as Predictors of Postoperative Delirium in Patients Undergoing Acute Type A Aortic Dissection Surgery
- Risk factors for postoperative hypoxemia in patients with Stanford type A aortic dissection
- Analysis of Postoperative Quality of Life in Patients With Acute Type A Aortic Dissection After Extensive Arch Repair via Partial Upper Sternotomy
BibTeX
@article{lai2026preoperative,
title = {{Preoperative risk factors and 180-day postoperative mortality in type a aortic dissection: a cohort study.}},
author = {Jiacheng Lai and Weier Wang and Fen Wang and Xiaofeng Yang},
journal = {BMC cardiovascular disorders},
year = {2026},
month = aug,
doi = {10.1186/s12872-026-06410-7},
url = {https://europepmc.org/article/MED/42958053},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Preoperative risk factors and 180-day postoperative mortality in type a aortic dissection: a cohort study.
AU - Jiacheng Lai
AU - Weier Wang
AU - Fen Wang
AU - Xiaofeng Yang
PY - 2026
DA - 2026/08/04
JO - BMC cardiovascular disorders
DO - 10.1186/s12872-026-06410-7
UR - https://europepmc.org/article/MED/42958053
AB - Objectives To explore modifiable risk factors associated with 180-day postoperative mortality based on preoperative examinations in patients with type A aortic dissection.Methods From August 2021 to November 2024,86 patients with TAAD attending the Emergency and Trauma Center of the First Affiliated Hospital,Zhejiang University School of Medicine were included in this study.The primary endpoint was follow-up of patients 180 days after operation.Results 25 (29.07%) of the 86 patients were dead within 180-day, with preoperative cardiac arrest and postoperative multiple organ failure being the primary causes of death. Comparison of baseline data between the survivors and the 180-day postoperative mortality revealed statistically significant differences in gender, age, mean arterial pressure, lactate, hemoglobin, D-dimer, fibrinogen, albumin, ST-T abnormalities, impaired intestinal blood supply, coronary artery bypass graft surgery, and GERAADA score (P < 0.05). By multivariate logistic regression analysis, fibrinogen, albumin, ST-T abnormalities, and impaired intestinal blood supply were risk factors of 180-day postoperative mortality, while gender was a protective parameter of 180-day postoperative mortality.Conclusions Preoperative risk stratification demonstrates significant predictive value for 180-day postoperative mortality in TAAD patients.Our findings identify a high-risk profile characterized by hypofibrinogenemia,electrocardiographic ST-T abnormalities,and intestinal malperfusion.A multimodal therapeutic approach incorporating aggressive preoperative fibrinogen replacement guided by ROTEM/TEG,consideration of visceral stenting prior to central repair in cases of severe malperfusion,high suspicion for coronary involvement in patients with ST-T abnormalities,may potentially reduce early postoperative mortality in this vulnerable population.
SN - 1471-2261
ER -