Open AccessImpact of renal dysfunction on surgical outcomes in patients with aortic dissection
Author(s) -
Pei-Yi Fan,
ChaoYu Chen,
ChengChia Lee,
KuoSheng Liu,
Victor ChienChia Wu,
PeiChun Fan,
MingYang Chang,
Jason C. Chang,
YaChung Tian,
Shaowei Chen
Publication year - 2019
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000015453
Subject(s) - medicine , aortic dissection , aortic aneurysm , dissection (medical) , cardiology , surgery , aorta
Preoperative renal dysfunction is associated with mortality in patients who undergo coronary artery bypass graft and valve surgery. However, the role of preoperative renal dysfunction in type A aortic dissection (TAAD) remains unclear. This study aimed to evaluate the impact of preoperative renal dysfunction on the outcome of surgical intervention in patients with TAAD. We retrospectively studied the outcomes of 159 patients with TAAD who were treated at a tertiary referral hospital between 2005 and 2010. The demographics and surgical details of patients were analyzed according to their renal function. Risk factors for outcomes were analyzed using multivariable logistic regression. Thirty-two of the patients (20.1%) had preoperative serum creatinine of 1.5 mg/dL or more. The multivariable logistic regression model revealed independent risk factors of in-hospital mortality to be renal dysfunction (odds ratio [OR], 3.79; 95% confidence interval [CI], 1.64–8.77), preoperative shock (OR, 8.75; 95% CI, 2.83–27.02), and bypass time (OR, 1.008; 95% CI, 1.003–1.013). In addition, patients with renal dysfunction exhibited a lower 90-day survival rate than did patients without the condition ( P of log-rank test = .005). Preoperative renal dysfunction may have a critical role in the surgical outcomes of patients with TAAD. Additional large-scale investigations are warranted.