Effect of stress-induced hyperglycemia on long-term mortality in non-diabetic patients with acute type A aortic dissection: a retrospective analysis

Figures & data

Figure 1. Patients’ flow chart of the cohort. AAAD: acute type A aortic dissection.

Figure 2. One-year Kaplan–Meier curves of patients in the normoglycemic group and SIH group.

Table 1. Baseline data grouped according to admission blood glucose levels.

Category	Normal blood sugar	High blood sugar	t/z/x^2	p-Value*
Age [M (P25, P75), years]	55.0 (47.0–64.0)	62.0 (56.0–65.0)	37.687	<0.001
Male [n (%)]	233	110	0.231	0.631
BMI ($\overline{x}\pm S,$ kg/m^2)	24.5 (21.6–26.7)	25.6 (23.4–29.1)	15.411	<0.001
Hypertension [n (%)]			0.512	0.916
Level 1	47 (15.3)	24 (16.1)
Level 2	75 (24.4)	24 (16.1)
Level 3	85 (40.4)	37 (24.8)
Respiratory diseases			2.641	0.450
COPD [n (%)]	21 (6.8)	9 (6.0)
Asthma [n (%)]	3 (0.9)	3 (2.0)
Chronic bronchitis [n (%)]	2 (0.6)	3 (2.0)
Drinking [n (%)]	137 (44.6)	66 (44.2)	0.004	0.947
Smoking [n (%)]	164 (53.4)	67 (44.9)	2.868	0.090
SBP [M (P25, P75), mmHg]	141.0 (127.0–153.0)	139.0 (123.0–155.0)	0.161	0.688
DBP [M (P25, P75), mmHg]	73.0 (66.0–81.0)	74.0 (65.0–81.0)	0.165	0.684
Heart rate ($\overline{x}\pm S,$ n)	75.0 (64.0–85.0)	74.0 (63.0–85.0)	1.366	0.242
Echocardiogram
Pericardial effusion (moderate/large)	19 (6.2)	21 (14.0)	7.833	0.005
Aortic regurgitation (moderate/severe)	51 (16.6)	28 (18.8)	0.333	0.564
EF ≥ 50%	235 (76.5)	103 (69.1)	0.537	0.437
Laboratory parameters
WBC [M (P25, P75), ×10^9/L]	10.59 (7.31–14.66)	10.66 (6.75–14.06)	0.441	0.507
Neutrophils [M (P25, P75), ×10^9/L]	8.53 (7.34–9.77)	8.7 (6.85–10.43)	0.054	0.816
Lymphocytes [M (P25, P75), ×10^9/L]	6.49 (3.68–13.46)	6.26 (3.69–14.93)	0.218	0.641
Platelets [M (P25, P75), ×10^9/L]	151.1 (108.5–198.2)	151.7 (112.0–185.3)	0.040	0.842
Hemoglobin [M (P25, P75), g/L]	121.4 (97.5–141.1)	127.2 (95.7–142.7)	0.400	0.527
BUN [M (P25, P75), mmol/L]	6.61 (5.14–9.27)	6.94 (5.31–9.40)	0.187	0.666
Creatinine [$\overline{x}\pm S,$ μmol/L]	72.0 (47.0–91.0)	67.5 (44.3–88.0)	0.094	0.759
Prothrombin time [M (P25, P75), s]	13.9 (13.6–14.2)	13.9 (13.5–14.2)	1.117	0.291
Blood vessels involved in CT
Coronary artery	41 (13.3)	32 (21.4)	4.921	0.027
Ascending aorta	217 (70.6)	102 (68.4)	0.237	0.626
Celiac artery	70 (22.8)	46 (30.8)	3.445	0.063
Superior mesenteric artery	77 (25.0)	41 (27.5)	0.310	0.578
Renal artery	83 (27.0)	48 (32.2)	1.314	0.252
Iliac artery	141 (45.9)	66 (44.2)	0.108	0.743
Operation time [M (P25, P75), min]	317.0 (283.0–343.0)	306.0 (287.0–329.0)	−1.640	0.101
CPB time [M (P25, P75), min]	164.0 (149.0–174.0)	173.0 (163.0–185.5)	−5.287	<0.001
ACC time [M (P25, P75), min]	71.0 (63.0–78.0)	76.0 (70.0–83.0)	−5.567	<0.001

n (%): number (percent); $\overline{x}\pm S:$ mean (standard deviation); M (P25, P75): median (interquartile range); BMI: body mass index; COPD: chronic obstructive pulmonary disease; EF: ejection fraction; SBP: systolic blood pressure; DBP: diastolic blood pressure; WBC: white blood cells; BUN: blood urea nitrogen; CPB: cardiopulmonary bypass; ACC: aortic cross-clamp; ICU: intensive care unit.

Data are expressed as number (percent) for categorical variables and as mean (standard deviation) for continuous variables in case of normal distributions and median (interquartile range) otherwise.

*Unpaired student’s independent t-test (when satisfying a normal distribution) or Mann–Whitney U test (when not satisfying a normal distribution) for quantitative variables and x-test for qualitative variables.

Table 2. Postoperative data stratified by glucose category.

Category	Normal blood sugar	High blood sugar	t/z/x^2	p-Value*
ICU stay time [M (P25, P75), d]	3.0 (2.0–5.0)	4.0 (2.0–5.0)	−2.180	0.029
Hospitalization time [M (P25, P75), h]	431.7 (342.4–551.08)	430.0 (348.2–648.3)	−2.882	0.004
Mechanical ventilation time [M (P25, P75), h]	23.0 (15.0–33.9)	23.0 (15.1–29.0)	−0.245	0.807
Acute kidney injury [n (%)]	50 (16.3)	41 (27.5)	7.920	0.005
Gastrointestinal bleeding [n (%)]	19 (6.2)	20 (13.4)	6.712	0.105
Pulmonary infection [n (%)]	94 (66.7)	47 (33.3)	0.040	0.841
Aortic dissection rupture [n (%)]	13 (4.2)	2 (1.3)	2.638	0.104
Cardiac insufficiency [n (%)]	57 (18.6)	35 (38)	1.510	0.219
Cerebral hemorrhage [n (%)]	2 (0.7)	1 (0.7)	0.001	0.981
Cerebral infarction [n (%)]	15 (4.9)	10 (6.7)	0.645	0.422
Delirium [n (%)]	16 (5.2)	16 (10.7)	4.695	0.030
Lower limb ischemia [n (%)]	7 (2.3)	16 (3.5)	14.984	<0.001
30-Day mortality rate [n (%)]	64 (20.8)	32 (21.5)	0.024	0.877
1-Year mortality rate [n (%)]	72 (23.5)	53 (32.7)	7.403	0.007

n (%): number (percent); $\overline{x}\pm S:$ mean (standard deviation); M (P25, P75): median (interquartile range); AKI: acute kidney injury.

Data are expressed as number (percent) for categorical variables and as mean (standard deviation) for continuous variables in case of normal distributions and median (interquartile range) otherwise.

*Unpaired student’s independent t-test (when satisfying a normal distribution) or Mann–Whitney U test (when not satisfying a normal distribution) for quantitative variables and x-test for qualitative variables.

Data availability statement

Data supporting the results of this study were available from the Wuhan Asian Heart Hospital. Still, the availability of these data was limited, and these data were used under license for this study and therefore not publicly available. However, information may be obtained from the corresponding author with permission from the Wuhan Asian Heart Hospital.