Neurological Complications and ICU Workload After Emergency Repair of Acute Type A Aortic Dissection

NCT07167628 | Completed

• 1 other identifier: CMUH114-REC1-139
• Study Type: observational
• Target: 274
• Locations: 1 country
• Sites: 1

Brief Summary

Single-center retrospective cohort at China Medical University Hospital (Taichung, Taiwan) using fully de-identified electronic health records. Consecutive adults who underwent emergency repair of acute type A aortic dissection between 2021-01-01 and 2025-04-30 were pooled into one cohort. The study measures the incidence and patterns of early postoperative neurological complications and evaluates their association with intensive care unit (ICU) resource use, focusing on prolonged ICU length of stay (LOS ≥ 10 days), ICU and hospital LOS, and duration of mechanical ventilation (MV). No new data collection or patient contact occurs. Institutional Review Board (IRB) approval: CMUH114-REC1-139.

Conditions

Aortic Dissection; Stroke; Paraplegia; AKI - Acute Kidney Injury; Coma; Delirium

Keywords

Acute type A aortic dissection; Neurological complications; Intensive care unit; ICU workload; ICU length of stay; Mechanical ventilation; Hospital length of stay; Retrospective cohort; Nursing workload; Taiwan

Outcome Measures

Primary Outcomes (2)

• Prolonged ICU length of stay (LOS ≥10 days)

  Proportion of participants with ICU LOS ≥10 days during the index ICU admission. Unit of measure: percent.

  Through ICU discharge during the index admission (up to 30 days).

• Any postoperative neurological complication

  Proportion with stroke (CT/MRI confirmed), other focal neurological deficits, paraplegia, or sustained coma/encephalopathy recorded by neurology consultation. Unit of measure: percent.

  Through hospital discharge during the index admission (up to 30 days).

Secondary Outcomes (5)

• ICU length of stay (days)

  Through ICU discharge during the index admission (up to 30 days).

• Duration of mechanical ventilation (hours)

  Through final extubation during the index hospitalization (up to 40 days).

• Hospital length of stay (days)

  Through hospital discharge during the index admission (up to 65 days).

• In-hospital mortality

  Through hospital discharge during the index admission (up to 30 days).

• In-hospital mortality within 30 days

  Up to 30 days after index surgery, during the index hospitalization.

Study Arms (1)

Adults undergoing emergency ATAAD repair

Single-center retrospective cohort of consecutive adults (≥18 years) who underwent emergency repair of acute type A aortic dissection at China Medical University Hospital between 2021-01-01 and 2025-04-30; all participants are pooled into one cohort with no protocol-assigned interventions; outcomes are obtained from de-identified records to assess neurological complications and ICU resource use.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Consecutive adults undergoing emergency repair of acute type A aortic dissection at a single tertiary centre ICU in Taichung, Taiwan (2021-01-01 to 2025-04-30).

You may qualify if:

• Adults (≥18 years) who underwent emergency repair of acute type A aortic dissection at China Medical University Hospital between 2021-01-01 and 2025-04-30.

You may not qualify if:

• Missing data in key variables required for analyses.
• Preoperative ischemic stroke within 30 days before surgery or preoperative modified Rankin Scale ≥4.
• Pregnancy.

Sponsors & Collaborators

• China Medical University Hospital: lead

Study Sites (1)

China Medical University Hospital

Taichung, Taichung City, 40447, Taiwan

Location

Related Publications (10)

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• Queijo AF, Martins RS, Andolhe R, Oliveira EM, Barbosa RL, Padilha KG. Nursing workload in neurological intensive care units: cross-sectional study. Intensive Crit Care Nurs. 2013 Apr;29(2):112-6. doi: 10.1016/j.iccn.2012.08.001. Epub 2012 Sep 19.

  PMID: 22999497 BACKGROUND

• Branch-Elliman W, Wright SB, Gillis JM, Howell MD. Estimated nursing workload for the implementation of ventilator bundles. BMJ Qual Saf. 2013 Apr;22(4):357-61. doi: 10.1136/bmjqs-2012-001372. Epub 2013 Feb 21.

  PMID: 23431219 BACKGROUND

• Lewis K, Balas MC, Stollings JL, McNett M, Girard TD, Chanques G, Kho ME, Pandharipande PP, Weinhouse GL, Brummel NE, Chlan LL, Cordoza M, Duby JJ, Gelinas C, Hall-Melnychuk EL, Krupp A, Louzon PR, Tate JA, Young B, Jennings R, Hines A, Ross C, Carayannopoulos KL, Aldrich JM. A Focused Update to the Clinical Practice Guidelines for the Prevention and Management of Pain, Anxiety, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. Crit Care Med. 2025 Mar 1;53(3):e711-e727. doi: 10.1097/CCM.0000000000006574. Epub 2025 Feb 21.

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• Liu H, Zhang S, Zhang C, Gao Q, Liu Y, Liao F, Ge S. Risk factors for prolonged postoperative ICU stay in the patients with Stanford type A aortic dissection. J Cardiothorac Surg. 2024 Feb 3;19(1):46. doi: 10.1186/s13019-024-02548-7.

  PMID: 38310273 BACKGROUND

• Dumfarth J, Kofler M, Stastny L, Plaikner M, Krapf C, Semsroth S, Grimm M. Stroke after emergent surgery for acute type A aortic dissection: predictors, outcome and neurological recovery. Eur J Cardiothorac Surg. 2018 May 1;53(5):1013-1020. doi: 10.1093/ejcts/ezx465.

  PMID: 29360972 BACKGROUND

• Biancari F, Herve A, Peterss S, Radner C, Buech J, Pettinari M, Rodriguez Lega J, Pinto AG, Fiore A, Onorati F, Francica A, Wisniewski K, Demal T, Conradi L, Rocek J, Kacer P, Gatti G, Vendramin I, Rinaldi M, Ferrante L, Pruna-Guillen R, Quintana E, DI Perna D, Mariscalco G, Jormalainen M, Field M, Harky A, Dell'aquila AM, Juvonen T, Makikallio T, Perrotti A. Predictors, prognosis and costs of prolonged intensive care unit stay after surgery for type A aortic dissection. Minerva Anestesiol. 2024 Jul-Aug;90(7-8):654-661. doi: 10.23736/S0375-9393.24.18210-7.

  PMID: 39021141 BACKGROUND

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  PMID: 27347762 BACKGROUND

MeSH Terms

Conditions

Aortic Dissection; Stroke; Paraplegia; Acute Kidney Injury; Coma; Delirium

Condition Hierarchy (Ancestors)

Dissection, Blood Vessel; Aneurysm; Vascular Diseases; Cardiovascular Diseases; Acute Aortic Syndrome; Aortic Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Paralysis; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Renal Insufficiency; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases; Unconsciousness; Consciousness Disorders; Neurobehavioral Manifestations; Confusion; Neurocognitive Disorders; Mental Disorders

Study Officials

• En-Bo Wu, MD

  Department of Anesthesiology, China Medical University Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 31, 2025
• First Posted: September 11, 2025
• Study Start: January 1, 2021
• Primary Completion: April 30, 2025
• Study Completion: April 30, 2025
• Last Updated: December 26, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

TW (1)