Predictors of Adverse Outcome and Transient Neurological Dysfunction Following Aortic Arch Replacement in 626 Consecutive Patients in China
Predictors of Adverse Outcome and Transient Neurological Dysfunction Following Aortic Arch Replacement in 626 Consecutive Patients in China
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DOI：
10.1016/j.hlc.2016.02.004
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发表时间：
2017-02-01
影响因子：
2.6
通讯作者：
Yu, CunTao
中科院分区：
文献类型：
--
作者：
Liu, Hong;Chang, Qian;Yu, CunTao
背景：主动脉弓手术的严重并发症是早期死亡和脑损伤，但来自亚洲国家的数据很少。我们回顾了在我们的机构进行主动脉弓置换术与深低温停循环（DHCA）和顺行选择性脑灌注（ASCP）的患者的结果，以分析术前和术中早期死亡和神经系统并发症的预测因素。方法对2005年1月至2011年12月期间接受主动脉弓置换术与DHCA加ASCP的成人患者的临床资料进行回顾性分析。采用单因素和多因素分析方法，对626例患者的30 d死亡率、永久性神经功能障碍（PND）和短暂性神经功能障碍（TND）进行分析。患者的平均年龄为45.0 ± 10.7岁，男性占多数（77.0%）。不良结局的发生率为5.8%，包括4.6%的30天死亡率和1.9%的PND。13.9%的患者出现一过性神经功能障碍。多因素Logistic回归分析显示，脑卒中（OR=7.846，95%CI：2.737-22.489，p
Background Early mortality and cerebral injury are severe complications of aortic arch surgery, but data from Asian countries are scarce. We reviewed the results of patients who underwent aortic arch replacement with deep hypothermic circulatory arrest (DHCA) and antegrade selective cerebral perfusion (ASCP) at our institution to analyse pre- and intraoperative predictors of early death and neurological complications.Methods Clinical data of adult patients who underwent aortic arch surgery with DHCA plus ASCP between January 2005 and December 2011 were retrospectively analysed. Univariate and multivariate analyses were performed to identify predictors of adverse outcome defined as 30-day mortality and permanent neurological dysfunction (PND), and transient neurological dysfunction (TND).Results A total of 626 patients were included in the study. The average age of the patients was 45.0 +/- 10.7 years with male predominance (77.0%). The incidence of adverse outcome was 5.8%, consisting of 4.6% 30-day mortality and 1.9% PND. Transient neurological dysfunction was found in 13.9% patients. Multiple logistic regression showed that stroke (OR=7.846, 95% CI: 2.737-22.489, p