Early and Late Mortality Predictors in Patients with Acute Aortic Dissection Type B. (26th November 2022)

• Record Type: Journal Article
• Authors: Lasica, Ratko M.; Perunicic, Jovan P.; Popovic, Dejana R.; Mrdovic, Igor B.; Arena, Ross A.; Radovanovic, Nebojsa L.; Radosavljevic-Radovanovic, Mina R.; Djukanovic, Lazar D.; Asanin, Milika R.
• Other Names: Simovic Stefan Academic Editor.
• Is Part Of: Cardiology research and practice. Volume 2022(2022)
• Publication Date: 2022-11-26
• Subjects: Cardiology -- Research -- Periodicals; Cardiology -- Periodicals; Cardiology; Cardiology; Cardiology -- Research; Electronic journals; Periodicals; Periodicals; 616.12
• DOI: 10.1155/2022/7869356
• Languages: English
• ISSNs: 2090-8016

Abstract

Abstract : 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 1 st, 1998 to January 1 st, 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.