Possible factors affecting the mortality rate in patients undergoing surgery for aortic type A dissection

Objectives: Aortic dissections of type A are clinical emergencies that can prove fatal if not managed promptly in specialized care facilities. Poor clinical management is the cause of approximately ۱% of deaths in patients; however, with advances in clinical practice, diagnostic imaging and clinician awareness, the mortality rate has been dramatically reduced to below ۳۰% in most international centers. We examined the potential factors involved in mortality after surgery for type A dissections.Methods: In this descriptive-analytical study, patients who underwent acute aortic dissection surgery in the Shahid Madani Hospital of Tabriz, Iran, between March ۲۰۰۹ and March ۲۰۲۰ were evaluated. Exclusion criteria included those who died before the surgery, patients with descending aortic dissection, and high-risk patients for surgery who were candidates for medical treatment. Among ۱۸۵ operated patients, ۱۳۷ were included. Males comprised ۶۲.۸% of the patients. Their mean (±SD) age was ۵۳.۹ (±۱۵.۳) years.Results: Age (p-value < ۰.۰۰۰۱), the presence of hypertension (p-value = ۰.۰۱۵), the amount of packed red blood cell transfusion (p-value = ۰.۰۲۴) and the amount of platelet transfusion (p-value = ۰.۰۱۸) were associated with increased mortality. Duration of intubation, use of fresh frozen plasma, postoperative drainage, duration of intensive care unit recovery, high serum creatinine, duration of aortic clamping, brain protection method, and smoking were not associated with increased mortality.Conclusions: These findings suggest that participants' mortality is dependent on several variables. Mortality of the patients with type A dissection can be reduced by interventions and reducing those factors.

کلیدواژه ها:

Aortic dissection ، mortality ، Risk factors