In-hospital mortality predictors after surgery for Stanford type A aortic dissection – single-center five-year experience

Abstract

Introduction/Objective Stanford type A aortic dissection is a surgical emergency associated with high mortality. The aim of this study was to determine which group of patients and which characteristics were associated with postoperative, in-hospital mortality.

Methods The retrospective study included 116 patients with type A aortic dissection surgically treated over a five-year period. The association between postoperative, in-hospital mortality and patient characteristics was examined.

Results Total postoperative, in-hospital mortality was 22.4% (26 out of 116 patients). The variables that, after a multivariate analysis, showed a direct correlation with mortality were as follows: admission creatinine value [OR 1.026 (1.006–1.046), p = 0.009], C-reactive protein (CRP) > 10 mg/L [OR 4.764 (1.066–21.283), p = 0.041], and stroke [OR 6.097 (1.399–26.570), p = 0.016]. The receiver operating characteristic (ROC) curve showed that creatinine could be a good predictor of mortality (area under the ROC curve = 0.767; p < 0.0005). The cut-off point was 124.5 µmol/L. The sensitivity was 65% and the specificity was 80%. The cut-off point for CRP was 14.5 mg/L – sensitivity 71.4%, specificity 75% (area under the ROC curve = 0.702, p = 0.021).

Conclusion Surgery for type A aortic dissection is still associated with relatively high mortality. A lower chance of survival may be indicated by elevated admission creatinine and CRP values, as well as stroke.

Keywords: aorta; dissection; mortality; creatinine; CRP; stroke