Predictors of in-hospital adverse outcomes in aortic surgery

Results We included 235 pts (61±13y, 66%male). Group 1 (aneurysms 61%) and Group 2 (dissections, ulcer, hematoma 36%). Others: 3%. Procedures: aortic root replacement (26,5%), Bentall procedure (23,5%), endovascular (28%), hybrid surgery (19%), aortoplasty and Tirone (3%); concomitant procedures in 20% of cases. Group 2 had higher BP, more urgent and hybrid procedures, greater pump/ ischemia time, smaller aortic size and less Bentall procedure. Mortality was 8,5% (Group 1, 4,6%; Group 2, 15,5%, p=0,004). Rate of MACCE was 19,2% (Group 1, 11,3%; Group 2, 33,7%, p < 0,001). Reoperation occurred in 7,3%, complications 34,2%, stroke 4,3%, AKIN 7,3%, respiratory complications 15,9%. Medullary ischemia developed in 2 patients (0,8%). By multivariate logistic regression, independent predictors of death were hybrid procedure [OR = 7,51 (1,05–53,4) p = 0,044], aortic size [OR = 1,05 (1,02-1,10) p = 0,005] and pump time [OR=1,10 (1,01–1,20) p = 0,034]; predictors of MACCE were urgent surgery [OR = 7,17 (1,10-49,5) p = 0,045], combined aneurysms [22,4 (1,42-353) p = 0,027], and concomitant mitral valve surgery [OR = 46,5 (1,3-166) p = 0,035]. Endovascular procedure was independently associated with reduction of MACCE incidence [OR = 0,05 (0,004-0,730) p = 0,045].