Acute Stanford type A aortic dissection (ATAAD) with sudden onset and high mortality requiries a standard Bentall operation and a accurate prognosis in common, together with alteration of CO combining power (COCP) and serum sodium rase concern, hence, we evaluated the prognostic value of COCP combined with serum sodium in ATAAD patients. This retrospective study included 183 patients who underwent Bentall operation for ATAAD from 2015 to 2021 in the Fourth Hospital of Hebei Medical University, subsequently followed grouping by the levels of COCP and serum sodium. The study endpoint was 30-day all-cause mortality, and the prognostic value of COCP combined with serum sodium levels in ATAAD patients were evaluated with multivariate logistic regression method. The postoperative incidence of in-hospital death and adverse events in patients with ATAAD were 18% and 25.7%, respectively. Combination of COCP and serum sodium for predicting ATAAD death and adverse events presented a higher predictive value than each single indicator with ROC curve analysis (the AUC of COCP combined with serum sodium was 0.786, 95% CI 0.706-0.869, P < 0.001), along with COCP < 22.5 mmol/L + serum sodium > 138.5 mmol/L group had the worst prognostic. Multivariate regression analyse showed that COCP < 22.5 mmol/L combined with serum sodium > 138.5 mmol/L preferably predicted the prognosis of ATAAD (OR =6.073, 95% CI 2.557-14.425, P < 0.001). Consistently, the cumulative 30-day survival after surgery in ATAAD patients with the low COCP and high serum sodium simultaneously was the worst (log-rank P < 0.05). The combination of COCP and serum sodium increases the predictive value of prognosis, which is conducive to risk stratification of patients with ATAAD.
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http://dx.doi.org/10.1038/s41598-022-27099-6 | DOI Listing |
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