Sex‐Related Differences in Clinical Features and In‐Hospital Outcomes of Type B Acute Aortic Dissection: A Registry Study

Background The association between female sex and poor outcomes following surgery for type A acute aortic dissection has been reported; however, sex-related differences in clinical features and in-hospital outcomes of type B acute aortic dissection, including classic aortic dissection and intramural hematoma, remain to be elucidated. Methods and Results We studied 2372 patients with type B acute aortic dissection who were enrolled in the Tokyo Acute Aortic Super-Network Registry. There were fewer and older women than men (median age interquartile range: 76 years 66-84 years, n=695 versus 68 years 57-77 years, n=1677; PPP=0.002), and had less end-organ malperfusion (2.4% versus 5.7%, PP=0.002) than men. In multivariable analysis, age (per year, odds ratio OR, 1.06 95% CI, 1.03-1.08; PP=0.019), painlessness (OR, 2.59 95% CI, 1.14-5.89; P=0.023), shock/hypotension (OR, 2.93 95% CI, 1.21-7.11; P=0.017), non-intramural hematoma (OR, 2.31 95% CI, 1.32-4.05; P=0.004), aortic rupture (OR, 26.6 95% CI, 14.1-50.0; PPP=0.072). Conclusions Women affected with type B acute aortic dissection were older and had more intramural hematoma, a lower incidence of end-organ malperfusion, and higher in-hospital mortality than men. However, female sex was not associated with in-hospital mortality after multivariable adjustment.