Risk factors for cerebral neurological injury after operation of acute Stanford type A aortic dissection / 中华胸心血管外科杂志

ABSTRACT

Objective To analyze risk factors for cerebral neurological injury after operation of acute Stanford type A aortic dissection.Methods Between January 2005 and December 2011,329 cases of acute Stanford type A aortic dissection patients underwent aortic arch replacement were retrospectively analyzed.Univariate and multivariate analysis(multiple logistic regression) were used to identify the risk factors for postoperative cerebral neurological injury including permanent neurological dysfunction (PND) and temporary neurological dysfunction (TND).Results Cerebral neurological injury occurred in 77 cases (23.4％),PND 11 cases(3.3％) and TND 66 cases(20.1％).Multiple logistic regression showed that age(OR =1.087,95％ CI 1.013-1.166,P =0.020) and stroke history (OR =10.383,95 ％ CI 1.596-67.534,P =0.014)were independent risk factors for PND,serum creatinin (OR =1.013,95 ％ CI 1.004-1.023,P =0.006),WBC (OR =1.199,95 ％ CI 1.087-1.324,P =0.000) and peak intraoperative glucose level (OR =1.011,95％ CI 1.004-1.018,P =0.003) were independent risk factors for TND.Conclusion The older age or stroke history indicate the occurrence of PND,Whereas the higher WBC lever preoperative or higher intraoperative glucose level indicate the occurrence of TND.The incidence of TND probably will be reduced by controlling intraoperative hyperglycemia actively.