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key=freeWeekly Mortality and neurologic injury after surgical repair with hypothermic circulatory arrest in acute and chronic proximal thoracic aortic pathology: effect of age on outcome. 急慢性近端胸主动脉病变在深低温停循环下行修复手术后的死亡率和神经损伤研究：年龄对预后的影响 Abstract摘要 BACKGROUND: 背景： The goal of this study was to determine whether advanced age affects mortality and incidence of neurological injury in patients undergoing surgical repair with hypothermic circulatory arrest in acute and chronic thoracic aortic pathology. 本研究的目的旨在确定年事已高是否影响接受深低温停循环手术修复治疗的急慢性近端胸主动脉病变患者的死亡率和发病率。 METHODS AND RESULTS: 方法和结果： A university center audit was done of 523 consecutive patients (median age, 64 years; interquartile range, 56-71 years) between 2005 and 2010. Mortality in acute type A aortic dissection (207 patients) was 9.7%, and in chronic ascending aortic aneurysms (316 patients) was 2.2% (P0.001). Neurological injury was observed in 16.9% of patients with acute type A aortic dissection (chronic ascending aortic aneurysms, 7.9%; P=0.002). Multivariable regression analysis revealed hypothermic circulatory arrest 40 minutes (odds ratio [OR], 4.21; 95% confidence interval [CI], 1.60-11.06; P=0.004) and redo surgery (OR, 3.44; 95% CI, 1.11-10.64; P=0.03) but not age (OR, 1.98; 95% CI, 0.73-5.38; P=0.18) as independent predictor of mortality. Emergency surgery (OR, 3.27; 95% CI, 1.31-8.15; P=0.01) and extracardiac arteriopathy (OR, 2.38; 95% CI, 1.26-4.50; P=0.008) but not age (OR, 1.80; 95% CI, 0.93-3.48; P=0.08) were independent predictors of neurological injury. 对2005年和2010年的523例患者进行研究（平均年龄64岁，四分位距，56-71岁）。急性A型主动脉夹层（207例）的死亡率为9.7％，而慢性升主动脉瘤（316例）为2.2％（P 0.001）。16.9％急性A型主动脉夹层患者可见神经损伤，（慢性升主动脉瘤为7.9％，P = 0.002）。多变量回归分析发现深低温停循环超过40分钟（比值比[OR]4.21; 95％可信区间[CI]，1.60-11.06，P = 0.004）与再做手术（OR，3.44; 95％CI，1.11-10.64 ，P = 0.03）是死亡率的独立预测因素，而不是年龄（OR，1.98;，P = 0.18，95％CI，0.73-5.38）。急诊手术（OR，3.27; 95％CI，1.31-8.15，P = 0.01）和心外动脉病变（OR，2.38; 95％CI，1.26-4.50，P = 0.008）是神经损伤的独立预测因素，但不是年龄（OR 1.80，95％CI ，0.93-3.48，P = 0