Increased risk for the development of postoperative severe hypoxemia in obese women with acute type a aortic dissection

Q: What are the key findings of this study?

Obese female patients were independently associated with a significantly increased risk of severe postoperative hypoxemia (OR 2.591) following surgery for acute type A aortic dissection.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Acute type A aortic dissection (n=112). Intervention: Obese female patients (Female + BMI) vs. Non-obese and/or male patients. Primary outcome: Severe postoperative hypoxemia (PaO2/FiO2 ≤ 100 mmHg) (OR 2.591, 95% CI 1.664 to 4.035, p=< 0.001).

Q: What does this research mean for the field?

Obese female patients have an independently increased risk of developing severe postoperative hypoxemia following surgery for acute type A aortic dissection. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Ming Gong; Zining Wu; Shijun Xu; Lei Li; Xiaolong Wang; Xinliang Guan; Hongjia Zhang

doi:10.1186/s13019-019-0888-9

April 25, 2019Journal of Cardiothoracic SurgeryOpen Access

Increased risk for the development of postoperative severe hypoxemia in obese women with acute type a aortic dissection

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Key result

Female obesity linked to ~159% greater risk of severe hypoxemia after acute type A dissection surgery.

OR 2.591
95% CI 1.664 to 4.035
P<0.001
n=112

Figures

Why the study?

The study was conducted to identify the risk factors for postoperative severe hypoxemia following surgery for acute type A aortic dissection.

What are the risk factors for postoperative severe hypoxemia in patients undergoing urgent aortic arch surgery for acute type A aortic dissection?

Study Design

Type

Cohort (n=112)

Multicenter

No

Structured PICO

What are the risk factors for postoperative severe hypoxemia in patients undergoing urgent aortic arch surgery for acute type A aortic dissection?

P

Population

112 consecutive patients (mean age 47.7 years, 25.9% female) undergoing urgent aortic arch surgery for acute type A aortic dissection at a single center in China.

E

Exposure

Urgent aortic arch surgery (exposure: female sex and increased body mass index)

O

Outcome

Postoperative severe hypoxemia

Main Result

Odds Ratio: 2.591 (95% CI 1.664–4.035)

p-value: p=< 0.001

Limitations

Relatively small patient population from a single institution, subject to selection and information biases
Influence of surgeon experience and institutional philosophy on treatment decisions was not taken into account
Potential confounding by complex interactions among different organ systems due to the emergency nature of the surgery

Implication

Female sex and increased body mass index are strong independent risk factors for postoperative severe hypoxemia following surgery for acute type A aortic dissection.

Abstract

BACKGROUND: The purpose of this study is to identify the risk factors for postoperative severe hypoxemia after surgery for acute type A aortic dissection. METHODS: This was a single-center retrospective study including 112 consecutive patients undergoing urgent aortic arch surgery for acute type A aortic dissection between December 2016 and April 2017 at Beijing Anzhen Hospital. RESULTS: Multivariate logistic regression analysis identified female (OR, 12.978; 95% CI, 3.332 to 50.546; p < 0.001) and increased body mass index (OR, 1.473; 95% CI, 1.213 to 1.789; p < 0.001) as independent predictors of postoperative severe hypoxemia in patients with acute type A aortic dissection. CONCLUSIONS: Obesity and female were independent risk factors for postoperative severe hypoxemia in patients with acute type A aortic dissection. More attention should be paid to preventing postoperative severe hypoxemia in obese women with acute type A aortic dissection.

Discussion

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Cite This Study

Gong et al. (2019) conducted a cohort in Acute type A aortic dissection (n=112). Obese female patients (Female + BMI) vs. Non-obese and/or male patients was evaluated on Severe postoperative hypoxemia (PaO2/FiO2 ≤ 100 mmHg) (OR 2.591, 95% CI 1.664 to 4.035, p=< 0.001). Obese female patients were independently associated with a significantly increased risk of severe postoperative hypoxemia (OR 2.591) following surgery for acute type A aortic dissection.

synapsesocial.com/papers/6aa81ffdbb118c90a59f1f8f https://doi.org/10.1186/s13019-019-0888-9

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Increased risk for the development of postoperative severe hypoxemia in obese women with acute type a aortic dissection

Figures

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Increased risk for the development of postoperative severe hypoxemia in obese women with acute type a aortic dissection

Figures

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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