Analysis of fatigue change trajsectories and postoperative cerebral dysfunction factors in acute type A aortic dissection patients

To identify distinct fatigue trajectories during the acute phase using latent class growth modelling and to investigate risk factors for postoperative cerebral dysfunction (POCD) in acute type A aortic dissection patients. A prospective analysis of patients who underwent acute type A aortic dissection (AAAD) surgery at Fujian Heart Medical Center from December 2023 to December 2024 was conducted. The odds ratio (OR) and 95% confidence interval were calculated by unconditional regression analysis to determine the independent risk factors for POCD. A total of 383 patients were included in this study. Among these patients, 174 (45.4%) experienced postoperative cognitive dysfunction. On the basis of the changes in the fatigue level of patients after AAAD, three potential categories of tracks were determined: the low-fatigue group ( n = 85), the increasing-fatigue group ( n = 259) and the severe-fatigue group ( n = 39). Among them, 10.2% of AAAD patients had a continuous high fatigue level track. With the increasing-fatigue group as the control, regression analysis revealed that the risk of POCD increased in the severe-fatigue group (OR = 2.454, P < 0.05) and the group with a cumulative duration of rcSO 2 < 50% and > 15 s (OR = 3.595, P < 0.05). Moreover, age (OR = 1.063, P < 0.001), BMI (OR = 1.138, P < 0.05), hypertension (OR = 3.697, P < 0.05) and arterial blood lactate level (OR = 1.093, P < 0.05) were independent risk factors for POCD after AAAD. Persistent high fatigue levels may be related to POCD in AAAD patients. In clinical work, it is necessary to pay attention to elderly and obese patients, patients with high arterial blood lactate values, and particularly patients with persistently abnormal fatigue levels, and to provide preventative medical and nursing interventions as soon as possible.