Management of Lower Limb Ischemia During Operative Repair of Acute Type A Aortic Dissection by Distal Crossover Grafts: a Case Series

Discomfort of postoperative patients with aortic dissection after discharge: telephone follow-up analysis of a cross-sectional study

Background

Postoperative discomfort is one of the important manifestations of disease changes, but few studies have reported detailed description of postoperative discomfort in patients with aortic dissection after discharge. The aim of this study is to investigate the discomfort symptoms and to explore the possible influencing factors of discomfort symptoms.

Method

This cross-sectional study based on convenience sampling collected medical records from 999 patients hospitalized in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of science and technology, Wuhan, Hubei, China from January 1, 2019 to December 31, 2019. Postoperative patients with first onset and confirmed aortic dissection were eligible for follow-up. Telephone follow-up was conducted from July 20, 2020 to August 20, 2020. Symptoms of discomfort were reported by patients or their immediate family members. Univariate and multivariable logistic regression analysis were performed to identify factors associated with symptoms of discomfort.

Results

A total of 675 patients were followed up, 185 patients (27.4%) were lost to follow-up, and the remaining 490 patients were divided into survival group (N = 428) and death group (N = 62) and were included in the study. There was no difference in gender and age among the three groups. 152 of 428 patients reported discomfort. The uncomfortable symptoms of postoperative patients were diverse, and mainly manifested as back and chest pain (32.24%, 49/152), chest tightness (15.79%, 24/152), dizzy (10.53%, 16/152) and weakness (10.53%, 16/152). Multivariable logistic regression analysis of postoperative discomfort showed length of discharge (OR 0.995; P 0.018; 95% CI 0.990–0.999) and positive history of drinking (OR 3.519; P 0.018; 95% CI 1.236–10.022) were significant among patients with Stanford A AD, and diagnosis was made in the first visiting hospital (OR 0.395; P 0.001; 95% CI 0.230–0.677) was a protective factor for patients.

Conclusions

The incidence of postoperative discomfort in patients with aortic dissection was high and the symptoms were diverse and not single. In order to reduce the possibility of postoperative discomfort, it is important to formulate effective public policies to limit the public to drink alcohol and timely diagnose aortic dissection. Long term follow-up is necessary for patients with aortic dissection to observe the recovery process of aortic dissection.