Background: The hydration state of the body is getting more and more attention from researchers. The purpose of this study is to investigate the relationship between impaired hydration status and postoperative hospitalization death in patients with A AAD.
Methods: From January 2019 to October 2021, the clinical data of 299 patients undergoing A AAD surgery were retrospectively analyzed. Patients were divided into normal hydration group, imminent dehydration group and current dehydration group according to the dehydration standard at admission. Univariate and multivariate logistic regression analysis were used to determine the independent risk factors for in-hospital death of patients with A AAD.
Results: Postoperative in-hospital death in A AAD patients was significantly more common in the imminent and current dehydration groups (> 295mmol/L) (26.7% vs 11.9%; P =0.001). The length of ICU stay was significantly longer in the impending and current dehydration groups (P < 0.05). After controlling for other factors by multivariate logistic regression analysis, the results showed that the group of impending and current dehydration (> 295) (OR=3.61, 95% confidence interval [CI]: 1.61– 8.06; P =0.002), CRRT (OR=10.55, 95%[CI]: 3.59– 31.01; P < 0.001), lactic acid (OR=1.25, 95%[CI]: 1.13– 1.38; P < 0.001), CAD (OR=5.27, 95%[CI]: 1.12– 24.80; P =0.035) was an independent risk factor for in-hospital death in A AAD patients. Albumin (OR=0.92, 95%[CI]: 0.85– 0.99; P =0.040) is a protective factor.
Conclusion: The presence of high serum osmotic pressure on admission of A AAD patients can independently predict postoperative death, and the impaired body hydration status should be paid attention to.
Keywords: acute type A aortic dissection, dehydration, death, surgery, outcome