Risk factors for in-hospital death in 2,179 patients with acute aortic dissection

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Long Wu¹  Lei Wang²  Qi Sun²  Yue Yuan²  Xiaowei Zhang²  Tiantian Wang²  Zehai Tang²  Wendan Wang²  Chen Chai³  Zhiyu Xia⁴ 

[1]Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

[2]Department of Emergency Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

[3]Department of Emergency Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

[4]Department of Emergency Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China

[5]Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

关键词: acute aortic dissection;    in-hospital death;    the risk prediction model;    admission time;    surgical treatment;   

DOI  :  10.3389/fcvm.2023.1159475

 received in 2023-02-06, accepted in 2023-04-11,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThis study aims to investigate the risk factors for in-hospital death in patients with acute aortic dissection (AAD) and to provide a straightforward prediction model to assist clinicians in determining the outcome of AAD patients.MethodsRetrospective analysis was carried out on 2,179 patients admitted for AAD from March 5, 1999 to April 20, 2018 in Wuhan Union Hospital, China. The risk factors were investigated with univariate and multivariable logistic regression analysis.ResultsThe patients were divided into two groups: Group A, 953patients (43.7%) with type A AAD; Group B, 1,226 patients (56.3%) with type B AAD. The overall in-hospital mortality rate was 20.3% (194/953) and 4% (50/1,226) in Group A and B respectively. The multivariable analysis included the variables that were statistically significant predictors of in-hospital death (P < 0.05). In Group A, hypotension (OR = 2.01, P = 0.001) and liver dysfunction (OR = 12.95, P < 0.001) were independent risk factors. Tachycardia (OR = 6.08, P < 0.001) and liver dysfunction (OR = 6.36, P < 0.05) were independent risk factors for Group B mortality. The risk factors of Group A were assigned a score equal to their coefficients, and the score of −0.5 was the best point of the risk prediction model. Based on this analysis, we derived a predictive model to help clinicians determine the prognosis of type A AAD patients.ConclusionsThis study investigate the independent factors associated with in-hospital death in patients with type A or B aortic dissection, respectively. In addition, we develop the prediction of the prognosis for type A patients and assist clinicians in choosing treatment strategies.

【 授权许可】

Unknown   
© 2023 Yuan, Xia, Wang, Sun, Wang, Chai, Wang, Zhang, Wu and Tang.