Risk Factors for Prolonged Mechanical Ventilation After Total Aortic Arch Replacement for Acute De gakey Type I Aortic Dissection
Risk Factors for Prolonged Mechanical Ventilation After Total Aortic Arch Replacement for Acute De gakey Type I Aortic Dissection
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DOI：
10.1016/j.hlc.2014.03.022
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发表时间：
2014-09-01
影响因子：
2.6
通讯作者：
Sun, Li-Zhong
中科院分区：
文献类型：
--
作者：
Li, Cheng-Nan;Chen, Lei;Sun, Li-Zhong
背景EuroSCORE II是一种客观风险评分模型。本研究的目的是评估EuroSCORE II在预测急性DeBakey I型主动脉夹层全主动脉弓置换术后长期机械通气方面的性能，并评价长期机械通气的风险因素。方法回顾性分析2009年2月至2012年2月240例DeBakey I型主动脉夹层患者行全主动脉弓置换术的临床资料。术后机械通气时间超过48 h定义为术后长时间机械通气。应用EuroSCORE II预测长期机械通气。采用C统计量（受试者工作特征曲线）检验模型的区分度。使用Hosmer-Lemeshow拟合优度统计评估校准。采用多元Logistic回归分析确定长期机械通气的最终危险因素。结果全组死亡率为10%。全主动脉弓置换术后的平均机械通气时间为42.72 ± 51.45小时。共74例患者需要长期机械通气。EuroSCORE II显示了较差的区分能力（C统计量0.52）和校准（Hosmer-Lemeshow，p 48.5岁（p 13.5 x10（9）/L（p
Background EuroSCORE II is an objective risk scoring model. The aim of this study was to assess the performance of EuroSCORE II in the prediction of prolonged mechanical ventilation following total aortic arch replacement for acute DeBakey type I aortic dissection and evaluate the risk factors for prolonged mechanical ventilation. Methods Between February 2009 to February 2012, data from 240 patients who underwent total aortic arch replacement for acute DeBakey type I aortic dissection were collected retrospectively. Mechanical ventilation after the surgery longer than 48 hours was defined as postoperative prolonged mechanical ventilation. EuroSCORE II was applied to predict prolonged mechanical ventilation. A C statistic (receiver operating characteristic curve) was used to test discrimination of the model. Calibration was assessed with a Hosmer-Lemeshow goodness-of-fit statistic. Multiple logistic regression analysis was used to identify the final risk factors of prolonged mechanical ventilation. Results The overall mortality was 10%. The mean length of mechanical ventilation after total aortic arch replacement was 42.72 +/- 51.45 hours. Total 74 patients needed prolonged mechanical ventilation. EuroSCORE II showed poor discriminatory ability (C statistic 0.52) and calibration (Hosmer-Lemeshow, p 48.5 years (p 13.5 x10(9)/L (p