ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology
Analysis of Prognosis and Risk Factors for Postoperative Hepatic Dysfunction in Patients with Acute Type A Aortic Dissection [Anatol J Cardiol]
Anatol J Cardiol. 2023; 27(4): 197-204 | DOI: 10.14744/AnatolJCardiol.2022.2644

Analysis of Prognosis and Risk Factors for Postoperative Hepatic Dysfunction in Patients with Acute Type A Aortic Dissection

Wei Sheng, Hui Qiao, Zhenbao Wang, Zhaozhuo Niu, Xiao Lv
Department of Cardiovascular Surgery, Qingdao Municipal Hospital, Medical College of Qingdao University, Qingdao, Shandong, China

Background: To explore the prognosis and risk factors of postoperative hepatic dysfunction in patients with acute type A aortic dissection.

Methods: A total of 156 patients who underwent surgery for acute type A aortic dissection in our hospital from May 2014 to May 2018 were retrospectively enrolled. The patients were divided into 2 groups based on postoperative liver function. The postop-erative model for end-stage liver disease score was used to define hepatic dysfunction. There were 35 patients with postoperative hepatic dysfunction (group hepatic dysfunction, model for end-stage liver disease score ≥ 15) and 121 patients without postoperative hepatic dysfunction (group non-hepatic dysfunction, model for end-stage liver disease score < 15). Univariate and multiple analyses (logistic regression) were used to identify the predictive risk factors.

Results: In-hospital mortality rate was 8.3%. Multiple logistic analysis showed that preoperative alanine aminotransferase (P <.001), cardiopulmonary bypass time (P <.001), and red blood cell transfusion (P <.001) were independent determinants for postoperative hepatic dysfunction. The patients were followed up for 2 years, with an average follow-up of 22.9 ± 3.2 months, and the lost follow-up rate was 9.1%. The short- and medium-term mortality in hepatic dysfunction group was higher than that in non-hepatic dysfunction group (log-rank P =.009).

Conclusions: The incidence of postoperative hepatic dysfunction is high in patients with acute type A aortic dissection. Preoperative alanine aminotransferase, cardiopulmonary bypass time, and red blood cell transfusion were independent risk factors for those patients. The short- and medium-term mortality in hepatic dysfunction group was higher than that in non-hepatic dysfunction group.

Keywords: Acute aortic dissection, hepatic dysfunction, risk factors, prognosis

Wei Sheng, Hui Qiao, Zhenbao Wang, Zhaozhuo Niu, Xiao Lv. Analysis of Prognosis and Risk Factors for Postoperative Hepatic Dysfunction in Patients with Acute Type A Aortic Dissection. Anatol J Cardiol. 2023; 27(4): 197-204

Corresponding Author: Xiao Lv
Manuscript Language: English


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