The relationship between different time periods and the prognosis of acute type A aortic dissection surgery

Objective Nowadays, emergency surgery is the most important method to treat acute type A aortic dissection. There are many factors that can affect the prognosis, but the relationship between time period and the prognosis of aortic dissection surgery has not been reported. Therefore, the purpose of this study was to explore the relationship between different time periods and the prognosis of acute type A aortic dissection surgery. Methods We retrospectively analyzed the characteristics of acute type A aortic dissection surgery in Fuwai Hospital from 2010 to 2015. All patients were divided into two groups according to different time period. Propensity matching analysis was used to compare in-hospital mortality and post-operative complications of these groups. Results There were 698 cases acute aortic dissection surgery during study period. 321 cases were operated in the nighttime(45.98%), the others were operated during daytime(54.02%). After propensity score matching, the operation time, extracorporeal bypass time, and the aortic blocking time of nighttime group were longer than daytime group, and there was a statistical difference(P<0.01). There was a statistical difference between the two groups of postoperative continuous renal replacement therapy. Nighttime group had higher incidence(15.94% vs. 5.64 %, P<0.01). There was statistically significant in 30-day mortality between daytime group and nighttime group(5.26% vs. 10.53%, P=0.03). The multiple-factor risk analysis of 30-day mortality in the whole group found that nighttime surgery was an independent risk factor(OR 2.13, 95%CI 1.19-3.81, P=0.01). Conclusion For acute type A aortic dissection surgery, nighttime surgery may be the important factor for increasing 30-day mortality. For relatively stable patients, avoiding nighttime surgery may increase survival rate. Key words: Aortic dissection; Prognosis; Mortality