Factors Associated With Operative Mortality Among Patients Admitted With Thoracic Aortic Aneurysm/dissection in Kenyatta National Hospital: a Retrospective Cohort Study

Abstract

Introduction: Thoracic aorta aneurysms (TAA) and Thoracic aorta dissection (TAD) are linked to significant morbidity and mortality. The incidence of death, undesirable postoperative complications and risk factors for mortality after undergoing open surgical repair for TAA/TAD remain largely unknown in Kenyatta National Hospital among patients undergoing management for TAA and TAD. Understanding the risk factors associated with operative mortality among patients with TAA and TAD would help improve patient selection for surgery hence reduce mortality and complications associated with the surgery. Objectives: The objective of this study was to determine the rate of operative mortality and the risk factors associated with operative mortality among patients who underwent thoracic artery aneurysm/dissection surgical repair. Methodology: This was a retrospective cross section study with a sample size of 31 cases. Data was collected from patient files retrieved from the records department at Kenyatta National Hospital. The study population included patients managed for thoracic aortic aneurysm/dissection at Kenyatta National Hospital from July 2010 to June 2020 through open surgical repair technique. Exposure variables were collected on socio-demographic, clinical factors, anatomical, radiological findings, intraoperative outcomes, the nature of the procedure done, time under Cardio-pulmonary bypass (CPB) and postoperative complications with the outcome variable as the 30-day mortality. Data analysis: Stata 13.0 was used for data analysis. Means and medians were used to describe characteristics of the study participants. For univariate risk factor analysis Chi................................................................