ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
Factors Influencing Early Postoperative Blood Pressure Goal Achievement after Endovascular Repair for Type B Aortic Dissection: Development of a Refined Nursing Monitoring Protocol
Dongmei Xu
Chen Chen
Zhen Wan
Tao Zhou
Nanjing Hospital, Nanjing Medical University (Nanjing First Hospital), Nanjing, China
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Abstract
Objective: To investigate the factors influencing the time to achieve early postoperative blood pressure (BP) goals in patients with type B aortic dissection (TBAD) following thoracic endovascular aortic repair (TEVAR) and to develop a refined nursing monitoring protocol. Methods: A retrospective cohort study was conducted, consecutively enrolling 142 TBAD patients who underwent TEVAR. Baseline patient characteristics, surgery-related indices, and postoperative indices were collected, with the primary observational endpoint being the time to achieve early postoperative BP goals. Univariate analysis and Cox regression analysis were employed to identify influencing factors. Based on the analytical results and combined with evidence-based practices, a refined nursing monitoring protocol was developed and refined using the Delphi expert consultation method. Results: The median time to achieve early postoperative BP goals among the 142 patients was 9.5 hours (interquartile range: 6.0-13.8 hours). Multivariate Cox regression analysis revealed that advanced age (HR = 0.97, P = 0.011), history of hypertension (HR = 0.54, P = 0.005), higher postoperative initial systolic BP (SBP) (HR = 0.976, P = 0.003), and elevated postoperative pain score (HR = 0.77, P = 0.002) were associated with a slower rate of achieving BP goals, thus identified as independent factors for prolonging the time to BP goal achievement. Conclusion: Advanced age, history of hypertension, higher postoperative initial SBP, and postoperative pain are independent factors prolonging the time to achieve BP goals in TBAD patients after TEVAR. The refined nursing monitoring protocol developed from these findings is targeted, systematic, and practical, providing an evidence-based framework for optimizing postoperative management, which holds potential for improving patient prognosis and warrants prospective validation.
Summary
Keywords
Endovascular repair, Monitoring Protocol, Refined Nursing, Time to bloodpressure goal achievement, type B aortic dissection
Received
30 December 2025
Accepted
09 February 2026
Copyright
© 2026 Xu, Chen, Wan and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Tao Zhou
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