ABSTRACT
Objective:
To study on the
association between vasoactive-inotropic score(VIS) and
mortality of total arch replacement in Stanford type A
aortic dissection(TAAD)
patients.
Methods:
Data of TAAD
patients admitted from January 2018 to November 2018 were analyzed retrospectively. According to the inclusion and exclusion criteria, 187
patients were finally included in the
analysis. 30-day
mortality was calculated and the
patients were divided into
death group(18 cases) and non-
death group(169 cases). The VIS at each
time point and perioperative indexes of the two groups were compared. The value of VIS in predicting
mortality was analyzed.
Results:
The 30-day
mortality was 9.63%(18/187). The operation
time,
cardiopulmonary bypass time,
ventilator assistance
time, the
incidence of
tracheotomy and major
postoperative complications in the
death group were significantly higher than those in the non-
death group( P<0.05). VIS of
death group was significantly higher than that of non-
death group( P<0.05). At each
time point, the area under
ROC curve(
AUC) of VIS was greater than 0.500( P<0.05), among which
AUC of ICU 48 h VIS was the largest(0.817), and the best cut-off point of ICU 48 h VIS was determined to be 9,
sensitivity 61.1%,
specificity 92.3%.
Logistic regression analysis showed that ICU 48 h VIS was an independent
risk factor for predicting the
death of total arch replacement in TAAD
patients( OR=1.465, 95% CI 1.194-1.796, P<0.001).
Conclusion:
When ICU 48 h VIS≥9, the
risk of
death was increased in
patients with total arch replacement of TAAD. VIS may be a useful reference index for predicting the
mortality of total arch replacement in TAAD
patients in the early
postoperative period.