Does female sex affect in-hospital mortality and clinical features in patients with type B acute aortic dissection?
Although women with type B acute aortic dissection have higher unadjusted in-hospital mortality than men, this difference is driven by age and clinical presentation rather than female sex itself.
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.
Takahashi et al. (2022) studied this question.