The prognostic impact of maximal aortic diameter on acute type B aortic dissection progression in a Chinese population

Abstract Currently, evidence concerning the link between maximal aortic diameter and in-hospital mortality in cases of acute type B aortic dissection (ATBAD) is insufficient. Thus, this study aimed to explore the relationship between the maximal aortic diameter at the time of admission and the early...

Full description

Saved in:
Bibliographic Details
Main Authors: Xianming Tang, Shuangfa Qiu, Xin Sun, Guifang Yang, Lijuan Sheng
Format: Article
Language:English
Published: Nature Portfolio 2024-10-01
Series:Scientific Reports
Subjects:
Online Access:https://doi.org/10.1038/s41598-024-77649-3
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850204418938503168
author Xianming Tang
Shuangfa Qiu
Xin Sun
Guifang Yang
Lijuan Sheng
author_facet Xianming Tang
Shuangfa Qiu
Xin Sun
Guifang Yang
Lijuan Sheng
author_sort Xianming Tang
collection DOAJ
description Abstract Currently, evidence concerning the link between maximal aortic diameter and in-hospital mortality in cases of acute type B aortic dissection (ATBAD) is insufficient. Thus, this study aimed to explore the relationship between the maximal aortic diameter at the time of admission and the early prognosis of patients diagnosed with ATBAD. A total of 678 patients with ATBAD were included between January 2016 and December 2018, during which their clinical data was gathered. The independent variable analyzed was the maximal diameter of the aorta, while the dependent variable was mortality during hospitalization. Factors considered in this analysis included the patients’ age, gender, body mass index (BMI), medical history of hypertension, stroke, diabetes, atherosclerosis, smoking habits, chronic kidney insufficiency, time until presentation, systolic and diastolic blood pressures, ejection fraction, presence of aortic regurgitation, symptoms, involvement of abdominal vessels, laboratory findings, and treatment approaches. Of these patients collected, the mean age was 56.03 ± 12.22 years, and approximately 82.45% of them were male. After analysis, it was found that the maximal aortic diameter of patients with ATBAD was positively correlated with in-hospital mortality (OR = 1.06, 95% CI 1.03 to 1.10). Surprisingly, a J curve relationship was detected between maximal aortic diameter (point 31 mm) and in-hospital death for patients with ATBAD. The effect sizes and confidence intervals of the right (maximal aortic diameter > 31 mm) and left (maximal aortic diameter ≤ 31 mm) aspects of the inflection point were 1.06 (1.02–1.11) and 1.03 (0.83–1.28), respectively. In addition, the stratified analysis showed a stable relationship between maximal aortic diameter and in-hospital mortality, while there was no significant difference in the interaction between different subgroups. In patients with ATBAD, a J-curve relationship was identified between the maximal aortic diameter and in-hospital mortality. Specifically, when the maximal aortic diameter exceeds 31 mm, a positive correlation with in-hospital death was observed.
format Article
id doaj-art-6bcd22a833774712aad5d79c07eade34
institution OA Journals
issn 2045-2322
language English
publishDate 2024-10-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj-art-6bcd22a833774712aad5d79c07eade342025-08-20T02:11:17ZengNature PortfolioScientific Reports2045-23222024-10-0114111110.1038/s41598-024-77649-3The prognostic impact of maximal aortic diameter on acute type B aortic dissection progression in a Chinese populationXianming Tang0Shuangfa Qiu1Xin Sun2Guifang Yang3Lijuan Sheng4Department of Emergency Medicine, The Second Xiangya Hospital, Central South UniversityDepartment of Emergency Medicine, The Second Xiangya Hospital, Central South UniversityCollege of Nursing, Changsha Medical UniversityDepartment of Emergency Medicine, The Second Xiangya Hospital, Central South UniversityClinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South UniversityAbstract Currently, evidence concerning the link between maximal aortic diameter and in-hospital mortality in cases of acute type B aortic dissection (ATBAD) is insufficient. Thus, this study aimed to explore the relationship between the maximal aortic diameter at the time of admission and the early prognosis of patients diagnosed with ATBAD. A total of 678 patients with ATBAD were included between January 2016 and December 2018, during which their clinical data was gathered. The independent variable analyzed was the maximal diameter of the aorta, while the dependent variable was mortality during hospitalization. Factors considered in this analysis included the patients’ age, gender, body mass index (BMI), medical history of hypertension, stroke, diabetes, atherosclerosis, smoking habits, chronic kidney insufficiency, time until presentation, systolic and diastolic blood pressures, ejection fraction, presence of aortic regurgitation, symptoms, involvement of abdominal vessels, laboratory findings, and treatment approaches. Of these patients collected, the mean age was 56.03 ± 12.22 years, and approximately 82.45% of them were male. After analysis, it was found that the maximal aortic diameter of patients with ATBAD was positively correlated with in-hospital mortality (OR = 1.06, 95% CI 1.03 to 1.10). Surprisingly, a J curve relationship was detected between maximal aortic diameter (point 31 mm) and in-hospital death for patients with ATBAD. The effect sizes and confidence intervals of the right (maximal aortic diameter > 31 mm) and left (maximal aortic diameter ≤ 31 mm) aspects of the inflection point were 1.06 (1.02–1.11) and 1.03 (0.83–1.28), respectively. In addition, the stratified analysis showed a stable relationship between maximal aortic diameter and in-hospital mortality, while there was no significant difference in the interaction between different subgroups. In patients with ATBAD, a J-curve relationship was identified between the maximal aortic diameter and in-hospital mortality. Specifically, when the maximal aortic diameter exceeds 31 mm, a positive correlation with in-hospital death was observed.https://doi.org/10.1038/s41598-024-77649-3Acute type B aortic dissectionMaximal aortic diameterIn-hospital mortality
spellingShingle Xianming Tang
Shuangfa Qiu
Xin Sun
Guifang Yang
Lijuan Sheng
The prognostic impact of maximal aortic diameter on acute type B aortic dissection progression in a Chinese population
Scientific Reports
Acute type B aortic dissection
Maximal aortic diameter
In-hospital mortality
title The prognostic impact of maximal aortic diameter on acute type B aortic dissection progression in a Chinese population
title_full The prognostic impact of maximal aortic diameter on acute type B aortic dissection progression in a Chinese population
title_fullStr The prognostic impact of maximal aortic diameter on acute type B aortic dissection progression in a Chinese population
title_full_unstemmed The prognostic impact of maximal aortic diameter on acute type B aortic dissection progression in a Chinese population
title_short The prognostic impact of maximal aortic diameter on acute type B aortic dissection progression in a Chinese population
title_sort prognostic impact of maximal aortic diameter on acute type b aortic dissection progression in a chinese population
topic Acute type B aortic dissection
Maximal aortic diameter
In-hospital mortality
url https://doi.org/10.1038/s41598-024-77649-3
work_keys_str_mv AT xianmingtang theprognosticimpactofmaximalaorticdiameteronacutetypebaorticdissectionprogressioninachinesepopulation
AT shuangfaqiu theprognosticimpactofmaximalaorticdiameteronacutetypebaorticdissectionprogressioninachinesepopulation
AT xinsun theprognosticimpactofmaximalaorticdiameteronacutetypebaorticdissectionprogressioninachinesepopulation
AT guifangyang theprognosticimpactofmaximalaorticdiameteronacutetypebaorticdissectionprogressioninachinesepopulation
AT lijuansheng theprognosticimpactofmaximalaorticdiameteronacutetypebaorticdissectionprogressioninachinesepopulation
AT xianmingtang prognosticimpactofmaximalaorticdiameteronacutetypebaorticdissectionprogressioninachinesepopulation
AT shuangfaqiu prognosticimpactofmaximalaorticdiameteronacutetypebaorticdissectionprogressioninachinesepopulation
AT xinsun prognosticimpactofmaximalaorticdiameteronacutetypebaorticdissectionprogressioninachinesepopulation
AT guifangyang prognosticimpactofmaximalaorticdiameteronacutetypebaorticdissectionprogressioninachinesepopulation
AT lijuansheng prognosticimpactofmaximalaorticdiameteronacutetypebaorticdissectionprogressioninachinesepopulation