Preoperative Ankle-Brachial Index and Renal Adverse Events After Acute Type A Aortic Dissection Surgery

This retrospective cohort study will evaluate whether a high preoperative ankle-brachial index is associated with postoperative renal adverse events in patients with acute Stanford type A aortic dissection who underwent surgical repair. The ankle-brachial index is a noninvasive vascular measurement that may reflect arterial stiffness and vascular calcification. A high ankle-brachial index may indicate abnormal vascular aging and impaired vascular compliance. The study will use existing clinical data from patients treated at Nanjing First Hospital, Nanjing Medical University, between January 2021 and February 2024. No intervention will be assigned as part of this study. The primary aim is to examine the association between a preoperative ankle-brachial index of 1.4 or higher and the risk of acute kidney injury within 7 days after surgery.

Inclusion Criteria: 1. Patients diagnosed with acute Stanford type A aortic dissection. 2. Patients who underwent surgical repair for acute Stanford type A aortic dissection at Nanjing First Hospital, Nanjing Medical University, between January 2021 and February 2024. 3. Patients aged 18 years or older. 4. Patients with available preoperative ankle-brachial index data. 5. Patients with available perioperative renal function data for assessment of postoperative renal outcomes. Exclusion Criteria: 1. Patients younger than 18 years. 2. Patients without available preoperative ankle-brachial index data. 3. Patients without sufficient perioperative serum creatinine data to assess postoperative acute kidney injury. 4. Patients with preoperative end-stage renal disease or maintenance dialysis. 5. Patients with incomplete key clinical data required for the main analysis.