Symptom characteristics in patients undergoing acute type A aortic dissection surgery post-discharge phase: a prospective observational study

TL;DR

This study examines the symptoms and needs of patients recovering from acute type A aortic dissection surgery three months after discharge.

Contribution

The study identifies distinct symptom subgroups in post-discharge AAAD patients and links them to risk factors like surgery duration and BMI.

Findings

Patients were categorized into three symptom subgroups: fatigue–sleep disturbance, anxiety–locomotion decline, and high symptom groups.

Longer cardiopulmonary bypass time, higher BMI, and decreased grip strength were associated with the high symptom group.

Unemployment status was linked to the anxiety–locomotion decline subgroup.

Abstract

In recent years, most studies on symptom characteristics in patients undergoing cardiac surgery have focused on the preoperative and postoperative phases. Relatively little knowledge is available related to the post-discharge phase. In this context, this paper aimed to analyze the symptoms and needs of patients with acute type A aortic dissection (AAAD) during the post-discharge phase.

We recruited and studied patients who underwent acute type A aortic dissection surgery at Fujian Heart Medical Center from June 2022 to August 2023. At 3 months following the surgery, these subjects were investigated using the general information questionnaire and relevant symptom assessment scales, including the Mini-Mental State Examination Scale (MMSE), Athens Insomnia Scale (AIS), Hospital Anxiety and Depression Scale (HADS), and Fatigue Severity Scale (FSS). Meanwhile, grip strength and average step per day were measured for the exercise endurance assessment. A latent class analysis (LCA) based on the symptoms was performed, and differences in demographic and disease characteristics among different subgroups of patients were identified and compared using multivariate logistic regression.

A total of 228 patients were enrolled and categorized into three latent classes: fatigue–sleep disturbance (44.3%), anxiety–locomotion decline (16.9%), and high symptom groups (38.8%). Results showed that patients with cardiopulmonary bypass time > 200 min, higher BMI, or decreased grip strength were more likely to be classified as the high symptom group and those were unemployment status have a higher possibility of being defined as the anxiety–locomotion decline group.

The symptom characteristics in patients with AAAD during the postoperative rehabilitation phrase exhibit heterogeneity. It is suggested that Clinical healthcare personnel improve the identification of symptoms in high-risk patients, particularly patients cardiopulmonary bypass time > 200 min, overweight or obese, unemployed status or decreased grip strength, relevant nursing interventions should be carried out to prevent the occurrence of surgical stress and complications in patients with AAAD early to improve the quality of life of patients.

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