In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 108, No. 10_suppl_1 ( 2003-09-09)
Abstract:
Background— Clinical profiles and outcomes of patients with acute type B aortic dissection have not been evaluated in the current era. Methods and Results— Accordingly, we analyzed 384 patients (65±13 years, males 71%) with acute type B aortic dissection enrolled in the International Registry of Acute Aortic Dissection (IRAD). A majority of patients had hypertension and presented with acute chest/back pain. Only one-half showed abnormal findings on chest radiograph, and almost all patients had computerized tomography (CT), transesophageal echocardiography, magnetic resonance imaging (MRI), and/or aortogram to confirm the diagnosis. In-hospital mortality was 13% with most deaths occurring within the first week. Factors associated with increased in-hospital mortality on univariate analysis were hypotension/shock, widened mediastinum, periaortic hematoma, excessively dilated aorta (≥6 cm), in-hospital complications of coma/altered consciousness, mesenteric/limb ischemia, acute renal failure, and surgical management (all P 〈 0.05). A risk prediction model with control for age and gender showed hypotension/shock (odds ratio [OR] 23.8, P 〈 0.0001), absence of chest/back pain on presentation (OR 3.5, P =0.01), and branch vessel involvement (OR 2.9, P =0.02), collectively named ‘the deadly triad’ to be independent predictors of in-hospital death. Conclusions— Our study provides insight into current-day profiles and outcomes of acute type B aortic dissection. Factors associated with increased in-hospital mortality (“the deadly triad”) should be identified and taken into consideration for risk stratification and decision-making.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/01.cir.0000087386.07204.09
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2003
detail.hit.zdb_id:
1466401-X
detail.hit.zdb_id:
80099-5
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