期刊
JOURNAL OF THE CHINESE MEDICAL ASSOCIATION
卷 83, 期 3, 页码 266-271出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/JCMA.0000000000000264
关键词
Aortic dissection; Creatinine; Mortality
资金
- National Key R&D Program of China [2017YFC1308000]
- Capital Health Development Research Project [2018-2-2066]
- National Natural Science Foundation of China [81600362]
Background: Acute Stanford type A aortic dissection is a lethal disease requiring surgery. Evidence regarding the effects of preoperative creatinine in mortality is limited, and few studies have evaluated the effect of postoperative dialysis treatment on it. Methods: In this cohort study, we continuously recruited 632 surgical patients who were treated for acute type A aortic dissection in our hospital between January 2015 and May 2017. The preoperative level of serum creatinine was measured. All patients were followed up after surgery for 30 days to determine early mortality. Results: The 30-day mortality after surgery increased with elevated levels of preoperative serum creatinine. Median (interquartile range) serum creatinine levels in survivors were 9.61 mu mol/dL (7.28-12.62 mu mol/dL) versus 13.41 mu mol/dL (10.28-20.63 mu mol/dL) in death (p < 0.01). Adjusted odds ratios for increasing per mu mol/dL serum creatinine were 1.09 (95% confidence interval, 1.03-1.15). We also found that the effect of preoperative creatinine on 30-day mortality was diminished by dialysis treatment after surgery. Conclusion: Preoperative serum creatinine predicts outcome in patients undergoing surgery for Stanford type A aortic dissection, and postoperative dialysis treatment can reduce its hazard.
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