Risk factors for postoperative hypoxemia in patients undergoing Stanford type A aortic dissection surgery

Objective To explore the risk factors for postoperative hypoxemia in patients undergoing Stanford type A aortic dissection surgery. Methods The clinical data of 77 patients with Stanford type A aortic dissection surgery were analyzed retrospectively. Among the patients, 40 patients occurred hypoxemia (hypoxemia group), and 37 patients did not occur hypoxemia (non- hypoxemia group). The preoperative, intraoperative and postoperative clinical data were compared between 2 groups, and the independent risk factors for postoperative hypoxemia were analyzed by multiple Logistic regression analysis. Results The incidence of postoperative hypoxemia in patients with Stanford type A aortic dissection was 51.9% (40/77). The multiple Logistic regression analysis result showed that age (OR= 1.088, 95% CI 1.018-1.164, P= 0.013), body mass index ≥ 25 kg/m2 (OR= 6.495, 95% CI 1.327- 31.789, P= 0.021), pericardial effusion (OR= 6.384, 95% CI 1.426-28.576, P= 0.015), white blood cell count (OR= 1.289, 95% CI 1.033-1.609, P= 0.024) and using recombinant human coagulation Ⅶ a (OR= 23.757, 95% CI 2.849-198.085, P= 0.003) were the independent predictive factors for postoperative hypoxemia in patients with Stanford type A aortic dissection. Conclusions The postoperative hypoxemia in patients with Stanford type A aortic dissection is related with perioperative systemic inflammation, especially in obese patients who should be given anti- inflammatory treatment during perioperative period. Control of bleeding and reducing the recombinant human coagulation Ⅶa as far as possible can reduce the incidence of postoperative hypoxemia. Key words: Aortic diseases; Anoxia; Risk factors; Retrospective studies