Differential impacts of clinical, anatomical, and procedural factors on early and late mortality following open thoracoabdominal aortic repair: a retrospective observational study

Autor: Jin Kyoung Kim, Gwan Sic Kim, Woo Seok Kim, Ho Jin Kim, Suk Jung Choo, Joon Bum Kim
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of Cardiothoracic Surgery, Vol 19, Iss 1, Pp 1-11 (2024)
Druh dokumentu: article
ISSN: 1749-8090
DOI: 10.1186/s13019-024-02933-2
Popis: Abstract Background The operative outcomes of thoracoabdominal aortic aneurysms (TAAAs) are challenged by high operative mortality and disabling complications. This study aimed to explore the baseline clinical, anatomical, and procedural risk factors that impact early and late outcomes following open repair of TAAAs. Methods We reviewed the medical records of 290 patients who underwent open repair of TAAAs between 1992 and 2020 at a tertiary referral center. Determinants of early mortality (within 30 days or in hospital) were analyzed using multivariable logistic regression models, while those of overall follow-up mortality were explored using multivariable Cox proportional hazards models and landmark analyses. Results The rates of early mortality and spinal cord deficits were 13.1% and 11.0%, respectively, with Crawford extent II showing the highest rates. In the logistic regression models, older age (P 0.05). Conclusion There were differential temporal impacts of perioperative risk variables on mortality in open repair of TAAAs, with older age and low hemoglobin level having significant impacts throughout the postoperative period, and low surgical volume, high CPB time, and Crawford extent II having impacts in the early postoperative phase.
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