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October 27, 2024Scientific Reports16 citationsOpen Access

The prognostic impact of maximal aortic diameter on acute type B aortic dissection progression in a Chinese population

XTXianming TangXSXin SunGYGuifang Yang

Key Result

In patients with acute type B aortic dissection, a maximal aortic diameter exceeding 31 mm was positively correlated with in-hospital mortality (OR 1.06 per 1 mm increase).

Study Design

Type

Observational (n=678)

Multicenter

No

Structured PICO

Does maximal aortic diameter at admission predict in-hospital mortality in patients with acute type B aortic dissection?

P
Population
678 patients with acute type B aortic dissection, with a mean age of 56 years and 17.6% female, evaluated for the association between admission maximal aortic diameter and in-hospital mortality.
E
Exposure
Maximal aortic diameter at admission (measured via computed tomography angiography)
C
Comparator
null
O
Outcome
In-hospital mortality (death due to various causes during hospitalization)hard clinical

In patients with acute type B aortic dissection, a maximal aortic diameter exceeding 31 mm at admission is independently associated with an increased risk of in-hospital mortality.

Main Result

Odds Ratio: 1.06 (95% CI 1.02–1.11)

p-value: p=0.001

Limitations

  • Derived from a Chinese population, which may limit generalizability to other populations with different genetic backgrounds or anthropometric characteristics.
  • Did not assess the status of false lumen thrombosis, a critical prognostic factor in patients with ATBAD.
  • Unavailability of data on blood pressure management prior to the event, which could impact aortic diameter measurements.

Abstract

Currently, evidence concerning the link between maximal aortic diameter and in-hospital mortality in cases of acute type B aortic dissection (ATBAD) is insufficient. Thus, this study aimed to explore the relationship between the maximal aortic diameter at the time of admission and the early prognosis of patients diagnosed with ATBAD. A total of 678 patients with ATBAD were included between January 2016 and December 2018, during which their clinical data was gathered. The independent variable analyzed was the maximal diameter of the aorta, while the dependent variable was mortality during hospitalization. Factors considered in this analysis included the patients' age, gender, body mass index (BMI), medical history of hypertension, stroke, diabetes, atherosclerosis, smoking habits, chronic kidney insufficiency, time until presentation, systolic and diastolic blood pressures, ejection fraction, presence of aortic regurgitation, symptoms, involvement of abdominal vessels, laboratory findings, and treatment approaches. Of these patients collected, the mean age was 56.03 ± 12.22 years, and approximately 82.45% of them were male. After analysis, it was found that the maximal aortic diameter of patients with ATBAD was positively correlated with in-hospital mortality (OR = 1.06, 95% CI 1.03 to 1.10). Surprisingly, a J curve relationship was detected between maximal aortic diameter (point 31 mm) and in-hospital death for patients with ATBAD. The effect sizes and confidence intervals of the right (maximal aortic diameter > 31 mm) and left (maximal aortic diameter ≤ 31 mm) aspects of the inflection point were 1.06 (1.02-1.11) and 1.03 (0.83-1.28), respectively. In addition, the stratified analysis showed a stable relationship between maximal aortic diameter and in-hospital mortality, while there was no significant difference in the interaction between different subgroups. In patients with ATBAD, a J-curve relationship was identified between the maximal aortic diameter and in-hospital mortality. Specifically, when the maximal aortic diameter exceeds 31 mm, a positive correlation with in-hospital death was observed.

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Cite This Study

Tang et al. (2024) conducted an observational in Acute type B aortic dissection (n=678). Maximal aortic diameter > 31 mm vs. Maximal aortic diameter ≤ 31 mm was evaluated on In-hospital mortality (OR 1.06, 95% CI 1.02-1.11, p=0.001). In patients with acute type B aortic dissection, a maximal aortic diameter exceeding 31 mm was positively correlated with in-hospital mortality (OR 1.06 per 1 mm increase).

synapsesocial.com/papers/6a9b5cdeabb488583b870825https://doi.org/10.1038/s41598-024-77649-3
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