Early and Late Mortality Predictors in Patients with Acute Aortic Dissection Type B

Background/Aim. Despite technological advances in diagnosis and treatment, in-hospital mortality with acute aortic dissection type B is still about 11%. The purpose of this study was to assess the risk factors for early and long-term adverse outcomes in patients with acute aortic dissection type B t...

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Main Authors: Ratko M. Lasica, Jovan P. Perunicic, Dejana R. Popovic, Igor B. Mrdovic, Ross A. Arena, Nebojsa L. Radovanovic, Mina R. Radosavljevic-Radovanovic, Lazar D. Djukanovic, Milika R. Asanin
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Cardiology Research and Practice
Online Access:http://dx.doi.org/10.1155/2022/7869356
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Summary:Background/Aim. Despite technological advances in diagnosis and treatment, in-hospital mortality with acute aortic dissection type B is still about 11%. The purpose of this study was to assess the risk factors for early and long-term adverse outcomes in patients with acute aortic dissection type B treated medically or with conventional open surgery. Methods. The present study included 104 consecutive patients with acute aortic dissection type B treated in our Center from January 1st, 1998 to January 1st, 2007. Patient demographic and clinical characteristics as well as in-hospital complications were reviewed. Univariate and multivariate testing was performed to identify the predictors of in-hospital (30-day) and late (within 9 years) mortality. Results. 92 (88.5%) patients were treated medically, while 12 (11.5%) patients with complicated acute aortic dissection type B were treated by open surgical repair. In-hospital complications occurred in 35.7% patients, the most often being acute renal failure (28%), hypotension/shock (24%), mesenteric ischemia (12%), and limb ischemia (8%). The in-hospital mortality rate was 15.7% and the 9-year mortality rate was 51.9%. Independent predictors of early mortality in patients with acute aortic dissection type B were uncontrolled hypertension (HR-20.69) and a dissecting aorta diameter >4.75 cm (HR-6.30). Independent predictors of late mortality were relapsing pain (HR-7.93), uncontrolled hypertension (HR-7.25), and a pathologic difference in arterial blood pressure (>20 mmHg) (HR-5.33). Conclusion. Knowledge of key risk factors may help with a better choice of treatment and mortality reduction in acute aortic dissection type B patients.
ISSN:2090-0597