A型主动脉夹层术后急性肾损伤的中期预后及相关危险因素分析OA

Objective To investigate the medium-term prognosis and related risk factors of acute kidney injury(AKI)af-ter surgery for Stanford type A aortic dissection(TAAD),and to provide evidence for the formulation of targeted clinical interven-tion strategies.Methods A total of 250 TAAD patients who underwent surgical treatment for TAAD at the First Affiliated Hos-pital of Air Force Medical University from January to December 2023 were enrolled.Their baseline data,surgical parameters,and postoperative recovery data were collected.According to KDIGO 2012 criteria,patients were divided into AKI group(165 cases)and non-AKI group(85 cases).Patients were followed up for 6 months and 1 year postoperatively to record changes in renal func-tion,complications,and survival.Multivariate Logistic regression was used to analyze the influencing factors of medium-term prognosis.Results At 6 months after surgery,the incidence of chronic kidney disease(CKD)in the AKI group was 38.8%,which was significantly higher than 11.8%in the non-AKI group(P<0.001).The 1-year follow-up showed that the cumulative survival rate in the AKI group was 76.4%,lower than 91.8%in the non-AKI group(P=0.002).Multivariate analysis indicated that preoperative hypertension history(OR=2.842,95%CI:1.456-5.547),preoperative white blood cell count≥10.58×109/L(OR=2.315,95%CI:1.183-4.531),postoperative 3-day hemoglobin<105 g/L(OR=3.107,95%CI:1.589-6.075),and AKI dura-tion≥72h(OR=4.263,95%CI:2.198-8.268)were independent risk factors for 1-year adverse prognosis.Conclusion Patients with AKI following TAAD surgery exhibit a high medium-term CKD incidence and lower survival rates.Preoperative hyperten-sion,elevated white blood cell count,postoperative anemia,and prolonged AKI duration are key factors influencing prognosis.Early clinical intervention is needed to improve the medium-term outcomes of patients.