Risk factors analysis for in-hospital death of acute Stanford type B aortic dissection

HUANG Shui-jin; CHEN Lu-yuan; LIU Yong; TAN ning; LUO Jian-fang; LI Li-wen

摘要：Background Data is limited regarding the correlation between related factors and in-hospital death of Stanford type B acute aortic dissection (AAD).Methods We registered consecutive Stanford type B AAD patients,who were in the Guangdong Cardiovascular Institute of Guangdong General Hospital from October 2010 to August 2011,and the onset day to admission day were less than or equal to 2 weeks.We collected in-hospital mortality,history of disease,laboratory parameters,some biochemical markers tests,treatment and so on,analyzed the relationship between risk factors and mortality.Results One hundred and five Stanford B AAD patients were enrolled,9 patients died,accounting for 8.6％.There are 24 patients treated with medicine,and 4 cases finally died.Endovascular aortic repair (EVAR) 62 cases,2 cases died.EVAR combined carotid artery bypass (CAB)19 eases,and 3 eases died.Among the three treatments,there was no significant difference in statistics (P =0.063).Compared with the survivors,the death group had higher D-dimer (P =0.016) and NT-proBNP (P =0.014) level,and more patients with myocardial infarction (P =0.007),hypotension or shock (P =0.019),acute renal failure (P =0.005),nervous system related events (P ＜ 0.001).After adjusting for other predictors of in-hospital death,logistic regression analysis shows that the nervous system related events (odds ratio:21.648;95％ CI:1.228-381.704,P =0.036 is the independent risk factor for death.Conclusions D-dimer,hypotension or shock,acute renal failure,nervous system related events are associated with hospitalization death of Stanford type B AAD patients,while nervous system related events is an independent risk factor for in-hospital death.[S Chin J Cardiol2012; 13(2):67-73]