Risk factors for hypoxemia after surgery for acute type A aortic dissection

Surg Today. 2006;36(8):680-5. doi: 10.1007/s00595-006-3226-5.

Abstract

Purpose: Postoperative hypoxemia is a frequent complication of surgery for acute type A aortic dissection. We tried to determine the factors associated with postoperative hypoxemia.

Methods: Between 1997 and 2003, 114 patients underwent surgery for acute type A aortic dissection. Multivariate logistic regression analysis was done to identify the independent predictors of postoperative hypoxemia, defined by an arterial partial oxygen/inspired oxygen fraction (PaO(2)/FiO(2)) ratio of 200 or lower.

Results: The overall in-hospital mortality was 6.1% (7 of 114 patients), being 5.2% in the hypoxemia group and 6.9% in the non-hypoxemia group. The ventilation time and intensive care unit stay were significantly longer in the hypoxemia group than in the non-hypoxemia group (P = 0.0044, P = 0.038, respectively). Logistic regression identified the following variables as predictors for postoperative hypoxemia: body mass index > or = 25 (odds ratio [OR], 5.6; 95% confidence interval [CI], 2.1-15.01; P < 0.001), preoperative PaO(2)/FiO(2) ratio < or = 300 (OR, 2.6; 95% CI, 1.09-6.13; P = 0.031), and the volume of transfused blood (OR, 1.08; 95% CI, 1.01-1.18; P = 0.037).

Conclusions: Initiating early treatment for hypoxemia and reducing the volume of blood transfused intraoperatively may improve the postoperative clinical course of obese patients with preoperative hypoxemia.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm / mortality
  • Aortic Aneurysm / surgery*
  • Aortic Dissection / mortality
  • Aortic Dissection / surgery*
  • Body Mass Index
  • Female
  • Humans
  • Hypoxia / etiology*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Oxygen / analysis
  • Partial Pressure
  • Postoperative Complications
  • Risk Factors

Substances

  • Oxygen