In-hospital outcome of type A aortic dissection repair in patients with chronic obstructive pulmonary disease: A population study of National Inpatient Sample from 2015 to 2020

• Published in: Cardiovascular revascularization medicine 2024-12, Vol.69, p.19-23
• Main Authors: Li, Renxi, Huddleston, Stephen J., Prastein, Deyanira J.
• Format: Article
• Language: English
• Subjects: Aged; Aortic Aneurysm - epidemiology; Aortic Aneurysm - mortality; Aortic Aneurysm - surgery; Aortic arch; Aortic dissection; Aortic Dissection - epidemiology; Aortic Dissection - mortality; Aortic Dissection - surgery; Ascending; Blood Vessel Prosthesis Implantation - adverse effects; Blood Vessel Prosthesis Implantation - mortality; Chronic obstructive pulmonary disease; Comorbidity; COPD; Databases, Factual; Female; Hospital Mortality; Humans; Inpatients; Length of Stay; Male; Middle Aged; Postoperative Complications - epidemiology; Postoperative Complications - mortality; Prevalence; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - epidemiology; Pulmonary Disease, Chronic Obstructive - mortality; Registries; Respiration, Artificial; Retrospective Studies; Risk Assessment; Risk Factors; Time Factors; Treatment Outcome; United States - epidemiology
• ISSN: 1553-8389; 1878-0938; 1878-0938
• DOI: 10.1016/j.carrev.2024.06.013

Chronic obstructive pulmonary disease (COPD) is a common comorbidity that has been linked to higher mortality and respiratory complications in cardiac surgery. However, the postoperative outcomes for COPD patients undergoing Type A Aortic Dissection (TAAD) repair remain unexplored. Thus, this study aimed to assess the impact of COPD on in-hospital outcomes of TAAD repair in a national registry. Patients undergoing TAAD repair were identified in National Inpatient Sample from the last quarter of 2015–2020. Multivariable logistic regressions were used to compare in-hospital outcomes between patients with and without COPD, where demographics, comorbidities, hospital characteristics, primary payer status, and transfer status were adjusted. There were 701 (16.37 %) COPD patients and 3581 (83.63 %) non-COPD patients who went under TAAD repair, where the prevalence of COPD was higher than in the general population (6 %). COPD and non-COPD patients have comparable rates of in-hospital mortality (14.69 % vs 15.19 %, aOR 1.016, 95 CI 0.797–1.295, p = 0.9) and there was no indication of delayed surgery. However, COPD patients had a higher risk of mechanical ventilation (37.80 % vs 31.42 %, aOR 1.521, 95 CI 1.267–1.825, p