Novel risk factors for the healthcare associated infections (HAIs) in patients with Stanford type A aortic dissection (TAAD)

Thoracic aortic dissection (TAD) occurs when blood flow is redirected from the aorta (true lumen) into the media of the aortic wall (false lumen), through an intimal laceration, creating a septum (1). Aortic dissection (AD) is a catastrophic disease process, with an age-dependent incidence ranging from between 3.5 and 6/100,000 person-years in the general population to as high as 10/100,000 person-years in the elderly (2,3). The Stanford system is applied widely to classify AD and surgical treatment is the primary choice for type A aortic dissection (TAAD) (4). Delay in diagnosis and surgical treatment is associated with increased mortality (5). Presentation with TAAD is associated with high mortality and a 5-year survival of 32%, with operative therapy indicated to improve survival (2,6,7). Besides, it is worth noting that TAAD underwent surgical procedures always included some clinical features which would were dramatically associated with elevated risks of HAIs, such as long duration of surgery, the application of mechanical ventilator, blood transfusion (8), femoral vein catheterization (9,10). Moreover, HAIs are deemed the most frequent adverse event threatening patients’ safety worldwide (11-13) which considerably increase the burden of in-patients, such as hospital acquired pneumonia (HAP), ventilator associated pneumonia (VAP), bloodstream infections (BSIs), surgical site infections (SSIs), gastrointestinal tract infection (GI). However, there are few studies on the risk factors and HAIs for the patients with TAAD after ascending aortic and arch replacement under deep hypothermic circulatory arrest (DHCA) during hospitalization. In this study, we aimed to identify the risk factors of HAIs for the patients following surgical repair of TAAD and optimized infection prevention