Risk Factors and Predictive Model Establishment of Postoperative Acute LungInjury in Stanford Type A Aortic Dissection Surgery
10.13241/j.cnki.pmb.2025.17.010
- VernacularTitle:Standford A型主动脉夹层术后急性肺损伤的危险因素分析及预测模型构建
- Author:
Sheng-qiang ZHANG
1
;
Shao-feng YANG
1
;
Chong-wen SHEN
1
;
Chao CAI
1
;
Wen-jie DIAO
1
;
Ge LIU
1
;
Chao SHI
1
Author Information
1. 蚌埠医科大学第一附属医院心脏外科 安徽 蚌埠 233000
- Publication Type:Journal Article
- Keywords:
Standford type A;
Aortic dissection;
Acute lung injury;
Risk factors;
Prediction model
- From:
Progress in Modern Biomedicine
2025;25(17):2797-2804
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Analyze the risk factors for acute lung injury of postoperative acute lung injury(ALI)in patients with Stanford type A aortic dissection(STAAD),and construct a nomogram predictive model.Methods:A retrospective cohort study design was adopted.A total of 112 patients with STAAD who underwent surgical treatment in our hopital from January 2021 to August 2024 were included.They were divided into two groups according to the occurrence of ALI after the surgical:non-ALI group(73 cases)and ALI group(39 cases).Clinical data were collected from both groups of patients.The influencing factors of postoperative ALI in patients with STAAD were analyzed by multivariate logistic regression.Established nomogram prediction model based on influencing factors and validated.Results:Among 112 patients with STAAD who underwent surgical treatment,39 case postoperative ALI occurred,with an incidence rate of 34.82％.Age,preoperative creatinine,body mass index(BMI),preoperative white blood cell count,preoperative lactate and other aspects compared,The difference were statistically significant(P＜0.05).The length of stay in the intensive care unit(ICU)of the ALI group was longer than that of the non ALI group(P＜0.05).The intraoperative red blood cell transfusion volume and extracorporeal circulation time in the ALI group were higher than those in the non ALI group(P＜0.05).Long intraoperative cardiopulmonary bypass time,high BMI,high intraoperative red blood cell transfusion volume and high preoperative white blood cell count were risk factors for postoperative ALI(P＜0.05).The receiver operating characteristic(ROC)curve analysis results show that,the Area under the curve(AUC)of the nomogram prediction model was 0.871.When the optimal critical value was 0.472,its sensitivity and specificity wew 0.887 and 0.776,respectively.The internal validation results of Bootstrap show that,the C-index of the column chart prediction model was 0.862,with an absolute error of 0.032.The calibration curve is close to the ideal curve and the original curve,with a slope close to 1.Conclusions:Long intraoperative cardiopulmonary bypass time,high BMI,high intraoperative red blood cell transfusion volume and high preoperative white blood cell count are independent risk factors for postoperative ALI in patients with STAAD.The nomogram model constructed based on the above risk factors can effectively evaluate the risk of postoperative ALI in patients with STAAD.
