Study on the association between vasoactive-inotropic score and mortality of total arch replacement in type A aortic dissection patients
10.3760/cma.j.cn112434-20191226-00459
- VernacularTitle:Stanford A型主动脉夹层全弓置换患者病死率与血管活性药物评分的关系
- Author:
Peng HOU
1
;
Zhenxiao JIN
;
Xiaochao DONG
;
Bo YU
;
Kai REN
;
Chao XUE
;
Shan LYU
;
Liqing JIANG
;
Weixun DUAN
;
Shiqiang YU
Author Information
1. 空军军医大学西京医院心血管外科，西安 710032
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2020;36(4):213-217
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study on the association between vasoactive-inotropic score(VIS) and mortality of total arch replacement in Stanford type A aortic dissection(TAAD) patients.Methods:Data of TAAD patients admitted from January 2018 to November 2018 were analyzed retrospectively. According to the inclusion and exclusion criteria, 187 patients were finally included in the analysis. 30-day mortality was calculated and the patients were divided into death group(18 cases) and non-death group(169 cases). The VIS at each time point and perioperative indexes of the two groups were compared. The value of VIS in predicting mortality was analyzed.Results:The 30-day mortality was 9.63%(18/187). The operation time, cardiopulmonary bypass time, ventilator assistance time, the incidence of tracheotomy and major postoperative complications in the death group were significantly higher than those in the non-death group( P<0.05). VIS of death group was significantly higher than that of non-death group( P<0.05). At each time point, the area under ROC curve(AUC) of VIS was greater than 0.500( P<0.05), among which AUC of ICU 48 h VIS was the largest(0.817), and the best cut-off point of ICU 48 h VIS was determined to be 9, sensitivity 61.1%, specificity 92.3%. Logistic regression analysis showed that ICU 48 h VIS was an independent risk factor for predicting the death of total arch replacement in TAAD patients( OR=1.465, 95% CI: 1.194-1.796, P<0.001). Conclusion:When ICU 48 h VIS≥9, the risk of death was increased in patients with total arch replacement of TAAD. VIS may be a useful reference index for predicting the mortality of total arch replacement in TAAD patients in the early postoperative period.
