Risk Factors of Hyperbilirubinemia after Acute Type A Aortic Dissection

Abstract

Objective: To explore the risk factors of hyperbilirubinemia after acute type A aortic dissection (ATAAD). Methods: Retrospective analysis of the data of 150 patients with ATAAD surgery in the First Affiliated Hospital of Gannan Medical University from 2021 to 2023. There were 117 males and 33 females. They were divided into patients according to the highest postoperative plasma total bilirubin level. Two groups, 85 cases in the hyperbilirubinemia group (HB group) total bilirubin (TBIL) >51.3 µmol/L; 65 cases in the non-hyperbilirubinemia group (NHB group) (TBIL <51.3 µmol/L). Two independent samples t-test was used to compare the two groups of samples, binary logistic regression analyzed the risk factors leading to postoperative HB, and the receiver operating characteristic (ROC) curve analyzed the critical values of the risk factors. Result: The incidence of postoperative HB was 56.7%. The preoperative plasma TBIL had an odds ratio (OR) of 1.213 (95% confidence interval (CI): 1.044–1.410, p = 0.012). The operation time had an OR of 1.019 (95% CI: 1.008–1.030, p = 0.001). The cardiopulmonary bypass (CPB) time had an OR of 1.053 (95% CI: 1.019–1.087, p = 0.022). The aortic cross-clamp time had an OR of 1.030 (95% CI: 1.006–1.055, p = 0.015). ROC curve analysis revealed critical values for preoperative plasma TBIL, operation time, CPB time, and aortic cross-clamp time as 12.95 µmol/L, 387.5 min, 190.5 min, and 117.5 min, respectively. Conclusion: HB is a frequently observed complication after surgery in patients with ATAAD, and it is associated with a poor prognosis. Several risk factors contribute to the increased occurrence of HB, including preoperative serum TBIL levels, operation time, CPB time, and aortic cross-clamp time.