Identification of factors associated with postoperative hemorrhage in Stanford type A aortic dissection repair
Presented During:
Thursday, April 25, 2024: 5:38PM - 7:00PM
Sheraton Times Square
Posted Room Name:
Central Park
Abstract No:
P0151
Submission Type:
Abstract Submission
Authors:
Qianyun Luo (1), Renxi Li (1), Stephen Huddleston (1)
Institutions:
(1) N/A, N/A
Submitting Author:
Qianyun Luo
-
Contact Me
N/A
N/A
Co-Author(s):
Renxi Li
-
Contact Me
N/A
N/A
Stephen Huddleston
-
Contact Me
N/A
N/A
Presenting Author:
Stephen Huddleston
-
Contact Me
N/A
N/A
Abstract:
Introduction: Postoperative hemorrhage is one of the leading causes of mortality and reoperation following Stanford type A aortic dissection (TAAD) repair. However, factors associated with postoperative hemorrhage in TAAD remain unclear. This study aimed to use the National Inpatient Sample (NIS), the largest all-payer inpatient care database in the United States, to provide a comprehensive assessment of the preoperative factors for hemorrhage after TAAD.
Methods: Patients who underwent TAAD repair between the last quarter of 2015-2020 were selected from the National Inpatient Sample (NIS) database. Multivariable logistic regression was employed to select preoperative variables that were either predictive or protective of post-operative hemorrhage in TAAD. Multicollinearity tests were examined to confirm independency for the selected factors.
Results: Among 4,282 TAAD cases, there were 3,302 (77.11%) incidences of hemorrhage. The preoperative risk factors for hemorrhage include thrombocytopenia (aOR 3.090, p<0.01), depression (aOR 1.560, p<0.01), renal malperfusion (aOR 1.543, p<0.01), transferred in from a different acute care hospital (aOR 1.285, p<0.01). In contrast, White race (aOR 0.787, p<0.01), elective surgery (aOR 0.768, p=0.02), age < 45 years old (aOR 0.729, p<0.01), drug abuse (aOR 0.669, p=0.02), and coronary malperfusion (aOR 0.591, p<0.01) were protective for hemorrhage following TAAD repair.
Conclusion: The study identified preoperative factors associated with postoperative hemorrhage after TAAD repair. These findings can be insightful for preoperative risk assessment and perioperative management in patients undergoing TAAD repair.
Methods: Patients who underwent TAAD repair between the last quarter of 2015-2020 were selected from the National Inpatient Sample (NIS) database. Multivariable logistic regression was employed to select preoperative variables that were either predictive or protective of post-operative hemorrhage in TAAD. Multicollinearity tests were examined to confirm independency for the selected factors.
Results: Among 4,282 TAAD cases, there were 3,302 (77.11%) incidences of hemorrhage. The preoperative risk factors for hemorrhage include thrombocytopenia (aOR 3.090, p<0.01), depression (aOR 1.560, p<0.01), renal malperfusion (aOR 1.543, p<0.01), transferred in from a different acute care hospital (aOR 1.285, p<0.01). In contrast, White race (aOR 0.787, p<0.01), elective surgery (aOR 0.768, p=0.02), age < 45 years old (aOR 0.729, p<0.01), drug abuse (aOR 0.669, p=0.02), and coronary malperfusion (aOR 0.591, p<0.01) were protective for hemorrhage following TAAD repair.
Conclusion: The study identified preoperative factors associated with postoperative hemorrhage after TAAD repair. These findings can be insightful for preoperative risk assessment and perioperative management in patients undergoing TAAD repair.
Aortic Symposium:
Dissection
Image or Table
