Effect of preoperative serum creatinine level on short-term prognosis in patients undergoing surgery for acute Stanford type A aortic dissection
Objective To investigate the effect of preoperative serum creatinine levels on the short-term prognosis of patients undergoing surgery for acute Stanford type A aortic dissection,providing clinical reference for early prevention and improvement of prognosis.Methods The clinical data of 76 patients with confirmed diagnosis of acute Stanford type A aortic dissection admitted in the Department of Cardiotho-racic Surgery,Wuhan Third Hospital from December 2018 to December 2021 were retrospectively ana-lyzed.Patients were divided into high creatinine level group and low creatinine level group according to preoperative serum creatinine level.The incidence of short-term postoperative complications and mortality of patients in the two groups were compared by independent-samples t-test and x2 test,and the relative risk factors of death were screened by logistic regression analysis.Results The incidence of mortality within 30 days postoperatively[17.14％(6/35)vs.2.44％(1/41),x2=4.882,P＜0.05],postoperative a-cute kidney injury[51.43％(18/35)vs.26.83％(11/41),x2=2.207,P＜0.05],continuous renal re-placement therapy(CRRT)[22.86％(8/35)vs.4.88％(2/41),x2=4.203,P＜0.05],postoperative acute lung injury[42.86％(15/35)vs.19.51％(8/41),x2=4.203,P＜0.05]and postoperative acute liver injury[31.43％(11/35)vs.12.20％(5/41),x2=4.842,P＜0.05]in the preoperative high cre-atinine group were significantly higher than in the preoperative low creatinine group.The result of logistic regression analysis suggested that preoperative high serum creatinine level was an independent risk factor for postoperative mortality[odds ratio(OR)=1.062,95％confidence interval(CI):1.029-1.096,P＜0.05].Conclusion Elevated preoperative serum creatinine level in patients undergoing surgery for acute Stanford type A aortic dissection led to increased postoperative complications and increased mortality with a poor short-term prognosis.
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