Predictors of hypoxemia in type-B acute aortic syndrome: a retrospective study

Sci Rep. 2021 Dec 3;11(1):23413. doi: 10.1038/s41598-021-02886-9.

Abstract

Acute aortic syndrome (AAS) can be life-threatening owing to a variety of complications, and it is managed in the intensive care unit (ICU). Although Stanford type-B AAS may involve hypoxemia, its predictors are not yet clearly understood. We studied clinical factors and imaging parameters for predicting hypoxemia after the onset of type-B AAS. We retrospectively analyzed patients diagnosed with type-B AAS in our hospital between January 2012 and April 2020. We defined hypoxemia as PaO2/FiO2 ≤ 200 within 7 days after AAS onset and used logistic regression analysis to evaluate prognostic factors for hypoxemia. We analyzed 224 consecutive patients (140 males, mean age 70 ± 14 years) from a total cohort of 267 patients. Among these, 53 (23.7%) had hypoxemia. The hypoxemia group had longer ICU and hospital stays compared with the non-hypoxemia group (median 20 vs. 16 days, respectively; p = 0.039 and median 7 vs. 5 days, respectively; p < 0.001). Male sex (odds ratio [OR] 2.87; 95% confidence interval [CI] 1.24-6.63; p = 0.014), obesity (OR 2.36; 95% CI 1.13-4.97; p = 0.023), patent false lumen (OR 2.33; 95% CI 1.09-4.99; p = 0.029), and high D-dimer level (OR 1.01; 95% CI 1.00-1.02; p = 0.047) were independently associated with hypoxemia by multivariate logistic analysis. This study showed a significant difference in duration of ICU and hospital stays between patients with and without hypoxemia. Furthermore, male sex, obesity, patent false lumen, and high D-dimer level may be significantly associated with hypoxemia in patients with type-B AAS.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Diseases / epidemiology*
  • Aortic Diseases / metabolism
  • Female
  • Fibrin Fibrinogen Degradation Products / metabolism*
  • Humans
  • Hypoxia / epidemiology*
  • Hypoxia / metabolism
  • Intensive Care Units
  • Length of Stay
  • Logistic Models
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies

Substances

  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D