Key result
Liver dysfunction linked to ~13-fold higher in-hospital mortality in type A AAD.
Why the study?
Risk factors for in-hospital death in patients with acute aortic dissection were not well defined, and a prediction model to assist clinicians was needed.
Cohort (n=2,179)
No
Odds Ratio: 12.95 (95% CI 4.05–41.38)
p-value: p=<0.001
Hypotension and liver dysfunction are independent risk factors for in-hospital mortality in type A acute aortic dissection, while tachycardia and liver dysfunction predict mortality in type B.
May guide risk stratification and monitoring in acute aortic dissection; leaves open need for prospective validation and intervention trials.
Background This 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. Methods Retrospective 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. Results The 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. Conclusions This 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.
No takes yet. Share an insight, caveat, or question.
Yuan et al. (2023) conducted a cohort in Acute aortic dissection (n=2,179). Liver dysfunction vs. Normal liver function was evaluated on In-hospital death (Type A AAD) (OR 12.95, 95% CI 4.05-41.38, p=<0.001). Liver dysfunction was the strongest independent risk factor for in-hospital death in both type A (OR 12.95) and type B (OR 6.36) acute aortic dissection.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: