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Management trends and early mortality rates for acute type B aortic dissection: a 10-year single-institution experience.

Abstract：

:This study was undertaken to assess trends in management over time and to determine predictors of early mortality for acute type B aortic dissection. Fifty-three consecutive patients with acute type B aortic dissection over a 10-year period were reviewed. Baseline demographics as well as in-hospital data regarding symptoms, type of initial management, surgical indications, type of surgical intervention, and early mortality rates were collected. Independent predictors of early mortality were determined by logistic regression. Forty-one of 53 (77.4%) patients were initially managed medically with a total of 26 (49.1%) ultimately undergoing surgical repair during hospitalization. Crude early mortality was 30.8% in the surgical group vs. 14.8% in the medical group (p = 0.20). Improvements in early mortality were observed over time for surgery (58.3%, first half vs. 7.1%, second half; p = 0.019) and medical therapy (21.4%, first half vs. 7.7%, second half; p = 0.64). Early mortality was 50% in 16 patients having open aortic surgery vs. 0% in 10 patients undergoing endovascular stent graft repair (p < 0.005). Independent predictors of early mortality included only renal dysfunction (odds ratio [OR] 7.39), aortic rupture (OR 8.72), and date of admission during the study period (OR 0.712). Despite improvements over time in early mortality that appear associated with the increasing use of endovascular stent grafts, patient-specific factors are still the most important independent predictors of early mortality in acute type B aortic dissection.

journal_name

Ann Vasc Surg

journal_title

Annals of vascular surgery

authors

MacKenzie KS,LeGuillan MP,Steinmetz OK,Montreuil B

doi

10.1007/s10016-004-0007-8

subject

Has Abstract

pub_date

2004-03-01 00:00:00

pages

158-66

issue

2

eissn

0890-5096

issn

1615-5947

pii

S0890-5096(06)61114-X

journal_volume

18

pub_type

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