Key result
Perioperative mass transfusion was predictive of in-hospital mortality (OR 3.308, p<0.001) but did not influence survival after discharge (OR 1.205, p=0.661) in acute Type A aortic dissection.
Why the study?
The study was conducted to analyze the influence of mass transfusion on postoperative outcomes and survival in patients presenting with acute Type A aortic dissection.
Does mass transfusion affect in-hospital mortality and survival after discharge in patients surgically treated for acute Type A aortic dissection?
Observational (n=505)
Does mass transfusion affect in-hospital mortality and survival after discharge in patients surgically treated for acute Type A aortic dissection?
In patients undergoing surgery for acute Type A aortic dissection, mass transfusion is associated with higher in-hospital mortality but does not negatively impact long-term survival among those who survive to discharge.
Answers are grounded in this paper and cite their sources.
Mass transfusion may worsen outcomes after acute Type A aortic dissection repair; hypothesis-generating and should not yet alter transfusion thresholds.
Background and Objectives: The aim of this study was to analyze the influence of mass transfusion on the postoperative outcome and survival in patients presenting with acute Type A aortic dissection. Materials and Methods: Between 2002 and 2020, a total of 505 patients were surgically treated for an acute Type A aortic dissection. Mass transfusion was defined as the peri- and postoperative replacement by transfusion of 10 units. Patient characteristics and outcomes were analyzed and compared between patients with and without mass transfusion. Results: Mass transfusion occurred in 105 patients (20%). The incidences of symptomatic coronary malperfusion (p = 0.017) and tamponade (p = 0.043) were higher in patients with mass transfusion. There was no statistically significant difference in the distal extension of the aortic dissection between the two groups. A valved conduit was significantly more common in patients with mass transfusion (p = 0.007), while the distal aortic repair was similar between the two groups. Cardiopulmonary bypass time (p < 0.001), cross clamp time (p < 0.001) and in-hospital mortality were significantly higher in patients with mass transfusion (p < 0.001), but the survival after discharge (landmark-analysis) showed equal survival between patients with and without mass transfusion (log rank: p = 0.4). Mass transfusion was predictive of in-hospital mortality (OR: 3.308, p < 0.001) but not for survival after discharge (OR: 1.205, p = 0.661). Conclusions: Mass transfusion is necessary in many patients with acute Type A aortic dissection. These patients present sicker and require longer surgery. However, mass transfusion does not influence survival after discharge.
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Benk et al. (2023) conducted an observational in Acute Type A aortic dissection (n=505). Mass transfusion vs. No mass transfusion was evaluated on In-hospital mortality (OR 3.308, p=<0.001). Perioperative mass transfusion was predictive of in-hospital mortality (OR 3.308, p<0.001) but did not influence survival after discharge (OR 1.205, p=0.661) in acute Type A aortic dissection.
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