Key result
Preoperative shock predicts in-hospital mortality in acute type A aortic dissection, not transport time.
Why the study?
Prognostic determinants in geographically stable populations with acute type A aortic dissection undergoing early surgical intervention remain incompletely defined.
Cohort
Yes
p-value: p=<.001
In patients undergoing surgery for acute type A aortic dissection, preoperative shock is a more significant predictor of in-hospital mortality than transport time, highlighting the critical need for early stabilization.
Hypothesis-generating for ATAAD mortality predictors in stable populations; prospective validation needed before broader adoption.
Background: In acute type A aortic dissection (ATAAD), early surgical intervention is critical; however, prognostic determinants in geographically stable populations remain incompletely defined. We sought to identify key predictors of in-hospital mortality in a closed regional cohort. Methods: We retrospectively analyzed patients undergoing surgery for ATAAD between January 2022 and June 2025 at 3 tertiary centers in Yamagata Prefecture, Japan. Demographics, transport time, admission to surgery interval, preoperative status, and operative variables were evaluated. Independent predictors of mortality were assessed by Cox proportional hazards modeling. Results: < .001), whereas transport time and operative complexity were not significant. Conclusions: In a geographically isolated, consistently managed cohort, preoperative shock was the dominant determinant of in-hospital mortality in ATAAD. These findings emphasize the importance of early recognition and stabilization before surgery rather than transport speed alone.
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Nakamura et al. (2026) conducted a cohort in Acute type A aortic dissection (ATAAD). Preoperative shock was evaluated on In-hospital mortality (p=<.001). Preoperative shock was the dominant determinant of in-hospital mortality in patients with acute type A aortic dissection (P<.001), whereas transport time and operative complexity were not significant.
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