Key result
Preoperative metabolic syndrome linked to ~17-fold higher postoperative hypoxemia risk in acute type A aortic dissection.
Why the study?
The association between metabolic syndrome and the incidence of hypoxemia after surgery for acute type A aortic dissection was unclear.
Is preoperative metabolic syndrome associated with an increased incidence of hypoxemia after surgery for acute type A aortic dissection?
Observational (n=271)
No
Is preoperative metabolic syndrome associated with an increased incidence of hypoxemia after surgery for acute type A aortic dissection?
Odds Ratio: 17.112 (95% CI 7.742–37.821)
Absolute Event Rate: 61.4% vs 9.3%
p-value: p=<0.001
Preoperative metabolic syndrome is an independent predictor of postoperative hypoxemia in patients undergoing surgery for acute type A aortic dissection.
METs may flag higher hypoxemia risk after ATAAD surgery; hypothesis-generating for targeted interventions, prospective trials needed.
Objectives. The aim of this study was to explore whether or to what extent metabolic syndrome (METs) and its components were associated with the incidence of hypoxemia in acute type A aortic dissection (ATAAD) patients after surgery. Design. Observational study. Methods. This study involved 271 ATAAD patients with surgery. Demographic and clinical data were collected. Subgroup analysis, mixed model regression analysis, and receiver operating characteristic (ROC) curve analysis were performed, and a scoring system was evaluated. Results. According to the PaO2/FiO2 ≤300 mmHg after the operation, the 271 inpatients were assigned to the hypoxemia group (n = 48) or no hypoxemia group (n = 223). Compared to the no hypoxemia group, the hypoxemia group had higher incidence of METs. Hypoxemia was present in 0%, 3.7%, 19.8%, 51.5%, 90.0% and 100% in the groups of individuals who met the diagnostic criteria of MetS 0, 1, 2, 3, 4 and 5 times, respectively. After adjustment for potential confounding factors, METs was an independent risk factor of hypoxemia in several models. After established the score system and assigned score for each METs component, the AUCs were 0.852 (95% CI: 0.789–0.914) in all patients, 0.728 (95% CI: 0.573–0.882) in patients with METs and 0.744 (95% CI: 0.636–0.853) in patients without METs by receiver operating characteristic analysis. Conclusions. METs was an independent risk of the incidence of hypoxemia in ATAAD after surgery.
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Zhang et al. (2022) conducted an observational in Acute type A aortic dissection (ATAAD) (n=271). Metabolic syndrome vs. No metabolic syndrome was evaluated on Incidence of hypoxemia (PaO2/FiO2 ≤ 300 mmHg) after surgery (OR 17.112, 95% CI 7.742-37.821, p=<0.001). Preoperative metabolic syndrome significantly increased the risk of postoperative hypoxemia in patients with acute type A aortic dissection (OR 17.112).
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