Risk factors and predictive values of unplanned reintubation after the surgery of acute type A aortic dissection
- VernacularTitle:急性A型主动脉夹层患者术后非计划再次气管插管的危险因素及其预测价值
- Author:
Jiawen HU
1
;
Yang YAN
1
;
Tao SHI
1
Author Information
- Publication Type:Journal Article
- Keywords: acute type A aortic dissection; reintubation; risk factor
- From: Journal of Xi'an Jiaotong University(Medical Sciences) 2022;43(4):534-538
- CountryChina
- Language:Chinese
- Abstract: 【Objective】 To analyze the risk factors of unplanned reintubation after the surgery of acute type A aortic dissection （ATAAD） and assess its predictive value. 【Methods】 The clinical data of 69 ATAAD patients， who underwent surgery in our department from January 2021 to June 2021， were retrospectively collected and analyzed. The operation procedure was performed based on the extent of dissection involved and the characteristics of aortic root lesions. The patients were divided into three groups based on whether weaning off ventilator and whether reintubation after weaning off. Perioperative and operative factors were compared among the three groups. 【Results】 The duration of surgery and circulatory arrest time were much longer in subjects of reintubation and those who did not wean off ventilator （P=0.005 and 0.036， respectively）. Compared to the group in which patients successfully weaned off ventilator， the first intubation time after surgery was longer ［（27.8（13.2， 71.1） h vs. 88.4（34.3， 114.9） h， P=0.013）］ and the use rate of non-invasive ventilator （NIV） was higher in reintubation group （P<0.001）. After adjusting for age， gender， BMI， hypertension， diabetes mellitus， chronic kidney diseases stage 5， and smoking， surgery time （OR=6.913， 95% CI：1.099， 43.484， P=0.039） and the use of NIV （OR=92.790， 95% CI： 4.932， 1 745.797， P=0.002） were independent risk factors for unplanned reintubation for ATAAD patients after surgery. Surgery duration > 7 h and the use of NIV could well predict the occurrence of unplanned reintubation. The area under ROC curve was 0.838 （95% CI： 0.729， 0.916）， the sensitivity and specificity were 83.3% and 84.2%， respectively. 【Conclusion】 Surgery duration and the need of NIV support were risk factors for unplanned reintubation after ATAAD.
