Gender-related differences of clinical features and perioperative treatment outcomes in patients with type A aortic dissection
10.3760/cma.j.cn112434-20230129-00018
- VernacularTitle:A型主动脉夹层患者临床特征及围手术期治疗结果的性别差异
- Author:
Zhiyu QIAO
1
;
Suwei CHEN
;
Chenhan ZHANG
;
Yipeng GE
;
Haiou HU
;
Ruidong QI
;
Chengnan LI
;
Yongmin LIU
;
Junming ZHU
Author Information
1. 首都医科大学附属北京安贞医院心外科 北京市心肺血管疾病研究所，北京 100029
- Keywords:
Type A aortic dissection;
Gender;
Aortic repair;
Clinical features;
Perioperative treatment
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2023;39(6):336-340
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To retrospectively analyze the gender differences in the clinical characteristics and perioperative outcomes of patients with type A aortic dissection in our institution.Methods:From January 2019 to January 2020, total 405 patients underwent surgical treatment for type A aortic dissection at Beijing Anzhen Hospital, including extensive aortic repair (total aortic arch replacement combined with stenting elephant trunk implantation) and limited aortic repair. In the entire cohort, male 295 cases, female 110 cases. All measures in this study were expressed as ± s or median(quartiles) and analyzed by Student t test for variables or non- parametric tests; count data were expressed as frequencies and percentages and analyzed by χ2 test and Fisher exact probability test. Independent risk factors were analyzed by logistic multivariate regression. Results:Females were older than males[(53.3 ± 12.4)years old vs. (47.1 ± 11.0)years old, P<0.001] and had significantly higher proportion of diabetes(9.1% vs. 4.1%, P=0.047) and previous cerebrovascular disease (11.8% vs. 5.8%, P=0.038). Females had a lower proportion of total aortic arch replacement combined with elephant trunk implantation (64.5% vs. 82.7%, P<0.001), while aortic cross-clamp time[168.0(144.8, 201.5) minutes vs. 190.0 (163.0, 217.0) minutes, P<0.001] and CPB time[99.0 (79.8, 118.0) min vs. 107.0 (91.0, 126.0) min, P=0.006] were significantly shorter than males. Females had significantly higher rates of pulmonary infection (14.5% vs. 5.8%, P=0.004) and stroke than males (15.5% vs. 8.1%, P=0.030). The difference in the proportion of postoperative deaths between female and male TAAD patients was not statistically significant (3.6% vs. 7.8%). Logistics multivariable regression analysis found that female was an independent risk factor for postoperative stroke ( OR=2.574, 95% CI: 1.198-5.531, P=0.015) and pulmonary infection ( OR=2.610, 95% CI: 1.180-5.772, P=0.018). Conclusion:Gender did not affect mortality after TAAD repair significantly, but females increased the risk of stroke and pulmonary infection after TAAD surgery.
