Clinical profiles and outcomes of acute type B aortic dissection in the current era: lessons from the International Registry of Aortic Dissection (IRAD)
Articolo
Data di Pubblicazione:
2003
Citazione:
Clinical profiles and outcomes of acute type B aortic dissection in the current era: lessons from the International Registry of Aortic Dissection (IRAD) / T. Suzuki, R.H. Mehta, H. Ince, R. Nagai, Y. Sakomura, F. Weber, T. Sumiyoshi, E. Bossone, S. Trimarchi, J.V. Cooper, D.E. Smith, E.M. Isselbacher, K.A. Eagle, C.A. Nienaber. - In: CIRCULATION. - ISSN 0009-7322. - 108:suppl. 2(2003 Sep 09), pp. 312-317.
Abstract:
Background - Clinical profiles and outcomes of patients with acute type B aortic dissection have not been evaluated in the current era.
Methods and Results - Accordingly, we analyzed 384 patients ( 65 +/- 13 years, males 71%) with acute type B aortic dissection enrolled in the International Registry of Acute Aortic Dissection (IRAD). A majority of patients had hypertension and presented with acute chest/back pain. Only one-half showed abnormal findings on chest radiograph, and almost all patients had computerized tomography (CT), transesophageal echocardiography, magnetic resonance imaging (MRI), and/or aortogram to confirm the diagnosis. In-hospital mortality was 13% with most deaths occurring within the first week. Factors associated with increased in-hospital mortality on univariate analysis were hypotension/ shock, widened mediastinum, periaortic hematoma, excessively dilated aorta ( greater than or equal to 6 cm), in-hospital complications of coma/altered consciousness, mesenteric/limb ischemia, acute renal failure, and surgical management ( all P < 0.05). A risk prediction model with control for age and gender showed hypotension/ shock ( odds ratio [ OR] 23.8, P = 0.0001), absence of chest/back pain on presentation ( OR 3.5, P = 0.01), and branch vessel involvement ( OR 2.9, P = 0.02), collectively named `the deadly triad' to be independent predictors of in-hospital death.
Conclusions - Our study provides insight into current-day profiles and outcomes of acute type B aortic dissection. Factors associated with increased in-hospital mortality ("the deadly triad") should be identified and taken into consideration for risk stratification and decision-making.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Aorta; Aortic dissection; Outcomes; Peripheral vascular disease; Stents
Elenco autori:
T. Suzuki, R.H. Mehta, H. Ince, R. Nagai, Y. Sakomura, F. Weber, T. Sumiyoshi, E. Bossone, S. Trimarchi, J.V. Cooper, D.E. Smith, E.M. Isselbacher, K.A. Eagle, C.A. Nienaber
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