Early and Long-Term Survival in Patients with Acute Kidney Injury after Acute Type A Aortic Dissection

P0115 

Abstract Submission 

Toshihito Gomibuchi (1), Tatsuichiro Seto (1)

(1) Shinshu University, Matsumoto, Japan

Toshihito Gomibuchi    -  Contact Me
Shinshu University

Tatsuichiro Seto    -  Contact Me
Shinshu University

Toshihito Gomibuchi    -  Contact Me
Suwa red cross hospital

Objective:
The overall incidence of acute kidney injury (AKI) after aortic surgery is well documented, but its impact on the outcome of acute type A aortic dissection (ATAAD) has not been thoroughly investigated.
The aim of this study was to determine the significance of AKI in predicting postoperative morbidity and mortality in ATAAD patients.
Methods:
We performed a retrospective review of a prospectively collected database including 520 patients who underwent aortic surgery for TA-AAD from September 2004 to February 2023. AKI was classified according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. We used a risk-adjusted Cox proportional hazards regression model to assess long-term survival.
Results:
Of 520 patients, 270 (51.9%) were diagnosed with AKI. The in-hospital mortality rates of AKI and non-AKI patients were significantly different (11.5% vs. 2.0%, respectively; P < 0.0001). Major risk factors for the development of AKI include male gender, visceral malperfusion, extended duration of cardiopulmonary bypass, and lower body temperature. Mean follow-up period was 51.3 ± 44.2 months. Long-term survival was significantly lower in patients with AKI (75.5% vs. 83.3% at 5 years, P = 0.0003). The Cox proportional hazards model identified AKI as an independent risk factor for increased long-term mortality (hazard ratio 1.61, P=0.04).
Conclusions:
Following surgery for acute aortic dissection, the development of acute kidney injury significantly increases the risk of in-hospital death and is an indicator of poor long-term prognosis.

Dissection