Table 1 Univariate analysis of possible risk factors for POD after AADS
Characteristic | Without POD n = 472 | With POD n = 220 | χ2 /Z/t | P |
|---|---|---|---|---|
Demographics | ||||
Age, (years), mean ± SD | 50.55 ± 10.38 | 57.98 ± 11.88 | 7.967 | < 0.001 |
Male, n (%) | 368 (78.0) | 179 (81.4) | 1.046 | 0.306 |
Body mass index, (kg/m2), mean ± SD | 25.26 ± 3.65 | 25.53 ± 4.04 | 0.844 | 0.399 |
Smoking history, n (%) | 189(40.0) | 89 (40.5) | 0.011 | 0.918 |
Drinking history, n (%) | 155 (32.8) | 125 (56.8) | 35.817 | < 0.001 |
Education level, n (%) | 2.485 | 0.289 | ||
Primary and below | 225 (47.7) | 119 (54.1) | ||
Middle school | 160 (33.9) | 66 (30.0) | ||
High school and above | 87 (18.4) | 35 (15.9) | ||
Nature of occupation, n (%) | 39.13 | < 0.001 | ||
Manual worker | 242 (51.3) | 168 (76.4) | ||
Non-manual worker | 230 (48.7) | 52 (23.6) | ||
Underlying conditions | ||||
Hypertension, n (%) | 348 (73.7) | 167 (75.9) | 0.375 | 0.540 |
Diabetes mellitus, n (%) | 45 (9.5) | 22 (10.0) | 0.037 | 0.847 |
Hyperlipidemia, n (%) | 34 (7.2) | 20 (9.1) | 0.743 | 0.389 |
Chronic obstructive pulmonary disease, n (%) | 26 (5.5) | 16 (7.3) | 0.819 | 0.365 |
Coronary heart disease, n (%) | 40 (8.5) | 25 (11.4) | 1.472 | 0.225 |
Moderate or severe AR, n (%) | 140 (29.7) | 75 (34.1) | 1.375 | 0.241 |
Renal dysfunction *, n (%) | 106 (22.5) | 74 (33.6) | 9.743 | 0.002 |
Malperfusion syndromes, n (%) | 1.709 | 0.789 | ||
Cerebral | 14 (21.2) | 17 (28.3) | ||
Myocardial | 11 (16.7) | 12 (20.0) | ||
Renal | 25 (37.9) | 17 (28.3) | ||
Iliofemoral | 8 (12.1) | 7 (11.7) | ||
Gastrointestinal | 8 (12.1) | 7 (12.7) | ||
Atrial fbrillation, n (%) | 12 (2.5) | 8 (3.6) | 0.640 | 0.424 |
Cardiac surgery history, n (%) | 33 (7.0) | 13 (5.9) | 0.283 | 0.595 |
General surgery history, n (%) | 65 (13.8) | 41 (18.6) | 2.738 | 0.098 |
NYHA class, n (%) | 1.144 | 0.766 | ||
1 | 239(50.6) | 114(51.8) | ||
2 | 169(35.8) | 74(33.6) | ||
3 | 40(8.5) | 17(7.7) | ||
4 | 24(5.1) | 15(6.8) | ||
Pericardial effusion (moderate or large), n (%), median (Q1, Q3) | 102 (21.6) | 53 (24.1) | 0.531 | 0.466 |
Diameter of the left atrium (cm), median (Q1, Q3) | 3.6 (3.0, 4.0) | 3.6 (3.2, 4.0) | 0.188 | 0.912 |
Diameter of the left ventricle (cm), median (Q1, Q3) | 4.9 (4.4, 5.4) | 4.8 (4.3, 5.4) | 0.952 | 0.302 |
Diameter of the right atrium (cm), median (Q1, Q3) | 3.8 (3.6, 4.0) | 3.7 (3.6, 4.1) | 0.273 | 0.785 |
Diameter of the right ventricle (cm), median (Q1, Q3) | 3.8 (3.5, 4.1) | 3.7 (3.5, 3.9) | 0.877 | 0.386 |
Left ventricular ejection fraction (%), median (Q1, Q3) | 60 (53; 65) | 59 (52; 64) | 0.440 | 0.575 |
Preoperative Laboratory values | ||||
White blood cell count (× 109/L), median (Q1, Q3) | 8.8 (6.7, 12.0) | 9.1 (7.0, 13.7) | 1.748 | 0.080 |
Red blood cell count (× 1012/L), median (Q1, Q3) | 5.0 (3.9, 5.6) | 4.9 (4.0, 5.3) | 1.006 | 0.240 |
Hemoglobin (g/L), median (Q1, Q3) | 122 (110, 140) | 119 (115, 140) | 0.232 | 0.807 |
Platelet count (× 109/L), median (Q1, Q3) | 172 (133, 220) | 158 (129, 199) | 1.386 | 0.112 |
Serum creatinine (μmol/L), median (Q1, Q3) | 89.2 (77.0, 118.6) | 106.5 (89.9, 128.8) | 2.840 | 0.005 |
Serum total bilirubin (umol/L), median (Q1, Q3) | 28.7 (23.6, 36.6) | 29.6 (26.9, 37.0) | 0.364 | 0.701 |
Serum albumin (g/L), median (Q1, Q3) | 38.5 (35.8, 42.5) | 38.0 (34.5, 41.0) | 0.288 | 0.796 |
Serum globulin (g/L), median (Q1, Q3) | 24.0 (22.0, 27.9) | 24.5 (22.5, 28.5) | 0.479 | 0.656 |
D-Dimmer (ug/L), median (Q1, Q3) | 182(48,372) | 198(38,309) | 0.552 | 0.588 |
IL-6 (pg/ml), median (Q1, Q3) | 53.15 (31.85, 95.60) | 118.42 (59.85, 169.60) | 9.866 | < 0.001 |
Intraoperative data | ||||
Catogeries of surgery, n (%) | 1.291 | 0.863 | ||
Isolated AAD surgery | 309 (65.5) | 143 (65.0) | ||
Combined valve surgery | 105 (22.2) | 44 (20.0) | ||
Combined coronary artery bypass grafting | 26 (5.5) | 14 (6.4) | ||
Combined valve and coronary surgery | 26 (5.5) | 15 (6.8) | ||
Combined other types of cardiac surgery | 6 (1.3) | 4 (1.8) | ||
Bispectral Index (BIS) | 40.54 ± 5.75 | 39.98 ± 5.88 | 1.184 | 0.237 |
Deep hypothermic circulatory arrest (mins), median (Q1, Q3) | 14.5 (12.0, 20.0) | 18.5 (15.0, 24.5) | 2.766 | 0.006 |
Cardiopulmonary bypass time (minutes), median (Q1, Q3) | 148 (104, 176) | 149 (105, 178) | 0.308 | 0.768 |
Aortic cross clamp time (minutes), median (Q1, Q3) | 59.5 (48.5, 69.2) | 61.8 (51.9, 70.7) | 1.039 | 0.207 |
Lowest temperature (°C), mean ± SD | 23.20 ± 2.85 | 23.29 ± 2.58 | 0.406 | 0.688 |
Transfusion of red blood cells (units), mean ± SD | 4.50 ± 3.85 | 4.84 ± 3.90 | 1.077 | 0.282 |
Transfusion of platelet (units), mean ± SD | 8.88 ± 3.60 | 9.80 ± 3.70 | 3.103 | 0.002 |
Postoperative data | ||||
APACHE-II, mean ± SD | 10.80 (3.50) | 18.89 (3.95) | 25.60 | < 0.001 |
Serum total bilirubin (umol/L), median (Q1, Q3) | 53.83(35.59, 87.57) | 106.68(65.50, 138.58) | 8.985 | < 0.001 |
AKI, n (%) | 8.481 | 0.037 | ||
Stage 1 | 36 (7.6)aa | 9(4.1)aa | ||
Stage 2 | 23(4.9)aa | 12(5.5)aa | ||
Stage 3# | 57(12.1)ab | 42(19.1)ab | ||
Analgesics and sedatives, n (%) | 202 (42.8) | 158 (71.8) | 50.64 | < 0.001 |
Ventilation time, h, median (Q1, Q3) | 40.0 (28.4, 63.6) | 60.0 (39.0, 115.7) | 3.203 | 0.003 |
ICU stay time, h, median (Q1, Q3) | 108.9(82.5, 170.5) | 166.5(116.5, 206.2) | 6.858 | < 0.001 |
Hospital time, d, median (Q1, Q3) | 17 (15, 22) | 21 (15, 25) | 2.763 | 0.038 |
Hospital costs, thousand dollars, median (Q1, Q3) | 33.83 (30.55, 43.24) | 39.80(33.65, 46.84) | 6.018 | < 0.001 |
In-hospital mortality, n (%) | 20(4.2%) | 19(8.6%) | 5.460 | 0.019 |