International Journal of General Medicine (Sep 2023)

Influence of Impaired Hydration Status on Postoperative in-Hospital Death in Patients with Acute Type A Aortic Dissection

  • Chen Y,
  • Peng Y,
  • Zhang X,
  • Chen L,
  • Lin Y

Journal volume & issue
Vol. Volume 16
pp. 4419 – 4428

Abstract

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Yaqin Chen,1,* Yanchun Peng,2,* Xuecui Zhang,1 Liangwan Chen,3 Yanjuan Lin2,4 1School of Nursing, Fujian Medical University, Fuzhou, People’s Republic of China; 2Department of Nursing, Union Hospital of Fujian Medical University, Fuzhou, People’s Republic of China; 3Department of Cardiac Surgery, Union Hospital of Fujian Medical University, Fuzhou, People’s Republic of China; 4Department of Cardiac Surgery Nursing, Union Hospital of Fujian Medical University, Fuzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yanjuan Lin, Department of Nursing, Union Hospital, Fujian Medical University, No. 29 Xinquan Road, Fuzhou, Fujian Province, 350001, People’s Republic of China, Tel +86 059186218336, Fax +8683344034, Email [email protected] Liangwan Chen, Department of Cardiac Surgery, Union Hospital, Fujian Medical University, No. 29 Xinquan Road, Fuzhou, Fujian Province, 350001, People’s Republic of China, Tel +86 059186218581, Fax +86059183301393, Email [email protected]: The hydration state of the body is getting more and more attention from researchers. The purpose of this study is to investigate the relationship between impaired hydration status and postoperative hospitalization death in patients with A AAD.Methods: From January 2019 to October 2021, the clinical data of 299 patients undergoing A AAD surgery were retrospectively analyzed. Patients were divided into normal hydration group, imminent dehydration group and current dehydration group according to the dehydration standard at admission. Univariate and multivariate logistic regression analysis were used to determine the independent risk factors for in-hospital death of patients with A AAD.Results: Postoperative in-hospital death in A AAD patients was significantly more common in the imminent and current dehydration groups (> 295mmol/L) (26.7% vs 11.9%; P=0.001). The length of ICU stay was significantly longer in the impending and current dehydration groups (P 295) (OR=3.61, 95% confidence interval [CI]: 1.61– 8.06; P=0.002), CRRT (OR=10.55, 95%[CI]: 3.59– 31.01; P< 0.001), lactic acid (OR=1.25, 95%[CI]: 1.13– 1.38; P< 0.001), CAD (OR=5.27, 95%[CI]: 1.12– 24.80; P=0.035) was an independent risk factor for in-hospital death in A AAD patients. Albumin (OR=0.92, 95%[CI]: 0.85– 0.99; P=0.040) is a protective factor.Conclusion: The presence of high serum osmotic pressure on admission of A AAD patients can independently predict postoperative death, and the impaired body hydration status should be paid attention to.Keywords: acute type A aortic dissection, dehydration, death, surgery, outcome

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