To analyze the perioperative survival rate and the relevant risk factors in patients with aortic dissection (AD), in order to provide clinical evidence for reducing mortality and improving prognosis.

A retrospective study was conducted between January 2007 and December 2015 on clinical and imaging data from 1211 AD patients treated successively at our hospital. Statistical analyses were conducted using Kaplan-Meier method to analyze overall survival (at 7, 14, 21, 30, and 60 days after hospital admission), and Log-rank tests were used to compare survival curves between groups. Additionally, multivariate step-wise Cox regression was used to identify relevant risk factors for perioperative survival.

Among the 1211 patients with AD, 171 died during the perioperative period. The survival rates at 7, 14, 21, 30, and 60 days were 86%, 83%, 76%, 70%, and 35%, respectively. Eleven factors including age, Stanford classification, carotid and celiac trunk and superior mesenteric artery involvement, renal perfusion, postoperative renal function, ascending aorta diameter, left ventricular ejection fraction, pericardial effusion, and preoperative FDP could significantly affect the perioperative survival rate of AD patients (χ²=5.057, 3.589, 7.673, 5.031, 5.902, 5.936, 9.936, 16.264, 4.754, 14.890, and 17.615, P<0.05). The 11 factors selected by Log-rank univariate analysis were included in the multivariate regression analysis, which showed that age over 50 years (RR=1.799, 95%CI: 1.027-3.151, P=0.040), aortic dissection involving the carotid artery (RR=2.603, 95%CI: 1.022-6.633, P=0.045), and aortic dissection involving the abdominal aorta (RR=2.293, 95%CI: 1.023-5.141, P=0.044) were independent factors for perioperative survival of patients with AD.

Age, carotid artery and celiac trunk involvement are key factors affecting the prognosis of AD patients. These factors should be clinically focused on and timely approaches should be carried out to improve the prognosis and survival rate of patients with AD.