The risk factors of postoperative continuous renal replacement therapy application in Stanford type A acute aortic dissection / 中华胸心血管外科杂志

ABSTRACT

Objective:To investigate the risk factors of postoperative continuous renal replacement therapy application in Stanford type A acute aortic dissection.Methods:This retrospective study included 527 patients with Stanford type A acute aortic dissection from November 2015 to February 2018 in Beijing Anzhen Hospital. They were divided into 2 groups according to whether or not needed postoperative continuous renal replacement therapy, group CRRT(78 cases) and group None CRRT(449 cases). Binary logistic regression analysis was used to analyze the risk factors of continuous renal replacement therapy. Results:Of all the patients, the percentage of using continuous renal replacement therapy was 14.8%(78/527), and the mortality of 30 days after surgery was 8.5%(45/527). The independent risk factors associated with CRRT were preoperative serum creatinine(sCr)( OR=1.012, 95% CI 1.005-1.019, P<0.001), transfusion of red blood cell in surgery( OR=1.141, 95% CI 1.071-1.216, P<0.001), transfusion of platelet in surgery( OR=1.307, 95% CI 1.084-1.576, P=0.005), the total amount of drainage( OR=1.000, 95% CI 1.000-1.000, P=0.036), and the time of extubation after surgery( OR=1.004, 95% CI 1.001-1.008, P=0.013). Conclusion:The risk factors of CRRT after emergency surgery of Stanford type A acute aortic dissection are preoperative serum creatinine, transfusion of red blood cell in surgery, transfusion of platelet in surgery, the total amount of drainage and the time of tracheal extubation after surgery. We need to focus on those risk factors in our daily job and manage them timely and properly, in order to improve patients’ prognosis.