Predictors of in-hospital mortality in patients with acute aortic dissection

Shih-Hung Chan, Ping-Yen Liu, Li Jen Lin, Jyh Hong Chen

Research output: Contribution to journalArticle

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Abstract

Background: If acute aortic dissection is a highly lethal disease. There were few reports addressing predictors of in-hospital mortality of this disease in southern Taiwan. Methods: If from January 1, 1989, to December 31, 2001, patients with acute aortic dissection were enrolled. Patient demographics, history, clinical characteristics, and laboratory examinations were reviewed. Univariate testing followed by logistic regression analysis was performed to identify the predictors of in-hospital mortality. Results: If in total, 198 (146 male) patients with mean age of 60.7±11.6 years were enrolled. The in-hospital mortality rate was 34.8% in overall patients, 58.8% for type A dissection, and 14.8% for type B dissection. There were five independent predictors of in-hospital mortality: presence of hypertension[odds ratio (OR)=0.09, 95% confidence interval (CI)=0.02∼0.36, p<0.001], type A dissection (OR=8.26, 95% CI=3.44∼19.60, p<0.001), probable extravasation (pericardial effusion in type A dissection or left side pleural effusion in patients with involvement of descending thoracic aorta)(OR=2.70, 95% CI=1.14∼6.41, p=0.024), visible intimal flap in ascending aorta in trans-thoracic echocardiography(OR=4.46, 95% CI=1.58∼12.60, p=0.005), and acute renal deterioration(OR=3.85, 95% CI=1.36∼10.87, p=0.011). Conclusions: If acute aortic dissection, especially type A, is with high mortality in southern Taiwan. There are five independent predictors of in-hospital mortality found in current analysis. Our result may remind doctors to find out their patients at high risk. Trans-thoracic echocardiography is a useful tool to find out patients at high risk because it is easily performed to check if there is pericardial effusion or visible intimal flap in ascending aorta.

Original languageEnglish
Pages (from-to)267-273
Number of pages7
JournalInternational Journal of Cardiology
Volume105
Issue number3
DOIs
Publication statusPublished - 2005 Dec 7

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Hospital Mortality
Dissection
Odds Ratio
Confidence Intervals
Tunica Intima
Pericardial Effusion
Thoracic Aorta
Taiwan
Echocardiography
Aorta
Thorax
Mortality
Pleural Effusion
Logistic Models
History
Regression Analysis
Demography
Hypertension
Kidney

All Science Journal Classification (ASJC) codes

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine

Cite this

@article{19aaea22d59849049148c55039d884dd,
title = "Predictors of in-hospital mortality in patients with acute aortic dissection",
abstract = "Background: If acute aortic dissection is a highly lethal disease. There were few reports addressing predictors of in-hospital mortality of this disease in southern Taiwan. Methods: If from January 1, 1989, to December 31, 2001, patients with acute aortic dissection were enrolled. Patient demographics, history, clinical characteristics, and laboratory examinations were reviewed. Univariate testing followed by logistic regression analysis was performed to identify the predictors of in-hospital mortality. Results: If in total, 198 (146 male) patients with mean age of 60.7±11.6 years were enrolled. The in-hospital mortality rate was 34.8{\%} in overall patients, 58.8{\%} for type A dissection, and 14.8{\%} for type B dissection. There were five independent predictors of in-hospital mortality: presence of hypertension[odds ratio (OR)=0.09, 95{\%} confidence interval (CI)=0.02∼0.36, p<0.001], type A dissection (OR=8.26, 95{\%} CI=3.44∼19.60, p<0.001), probable extravasation (pericardial effusion in type A dissection or left side pleural effusion in patients with involvement of descending thoracic aorta)(OR=2.70, 95{\%} CI=1.14∼6.41, p=0.024), visible intimal flap in ascending aorta in trans-thoracic echocardiography(OR=4.46, 95{\%} CI=1.58∼12.60, p=0.005), and acute renal deterioration(OR=3.85, 95{\%} CI=1.36∼10.87, p=0.011). Conclusions: If acute aortic dissection, especially type A, is with high mortality in southern Taiwan. There are five independent predictors of in-hospital mortality found in current analysis. Our result may remind doctors to find out their patients at high risk. Trans-thoracic echocardiography is a useful tool to find out patients at high risk because it is easily performed to check if there is pericardial effusion or visible intimal flap in ascending aorta.",
author = "Shih-Hung Chan and Ping-Yen Liu and Lin, {Li Jen} and Chen, {Jyh Hong}",
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Predictors of in-hospital mortality in patients with acute aortic dissection. / Chan, Shih-Hung; Liu, Ping-Yen; Lin, Li Jen; Chen, Jyh Hong.

In: International Journal of Cardiology, Vol. 105, No. 3, 07.12.2005, p. 267-273.

Research output: Contribution to journalArticle

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T1 - Predictors of in-hospital mortality in patients with acute aortic dissection

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N2 - Background: If acute aortic dissection is a highly lethal disease. There were few reports addressing predictors of in-hospital mortality of this disease in southern Taiwan. Methods: If from January 1, 1989, to December 31, 2001, patients with acute aortic dissection were enrolled. Patient demographics, history, clinical characteristics, and laboratory examinations were reviewed. Univariate testing followed by logistic regression analysis was performed to identify the predictors of in-hospital mortality. Results: If in total, 198 (146 male) patients with mean age of 60.7±11.6 years were enrolled. The in-hospital mortality rate was 34.8% in overall patients, 58.8% for type A dissection, and 14.8% for type B dissection. There were five independent predictors of in-hospital mortality: presence of hypertension[odds ratio (OR)=0.09, 95% confidence interval (CI)=0.02∼0.36, p<0.001], type A dissection (OR=8.26, 95% CI=3.44∼19.60, p<0.001), probable extravasation (pericardial effusion in type A dissection or left side pleural effusion in patients with involvement of descending thoracic aorta)(OR=2.70, 95% CI=1.14∼6.41, p=0.024), visible intimal flap in ascending aorta in trans-thoracic echocardiography(OR=4.46, 95% CI=1.58∼12.60, p=0.005), and acute renal deterioration(OR=3.85, 95% CI=1.36∼10.87, p=0.011). Conclusions: If acute aortic dissection, especially type A, is with high mortality in southern Taiwan. There are five independent predictors of in-hospital mortality found in current analysis. Our result may remind doctors to find out their patients at high risk. Trans-thoracic echocardiography is a useful tool to find out patients at high risk because it is easily performed to check if there is pericardial effusion or visible intimal flap in ascending aorta.

AB - Background: If acute aortic dissection is a highly lethal disease. There were few reports addressing predictors of in-hospital mortality of this disease in southern Taiwan. Methods: If from January 1, 1989, to December 31, 2001, patients with acute aortic dissection were enrolled. Patient demographics, history, clinical characteristics, and laboratory examinations were reviewed. Univariate testing followed by logistic regression analysis was performed to identify the predictors of in-hospital mortality. Results: If in total, 198 (146 male) patients with mean age of 60.7±11.6 years were enrolled. The in-hospital mortality rate was 34.8% in overall patients, 58.8% for type A dissection, and 14.8% for type B dissection. There were five independent predictors of in-hospital mortality: presence of hypertension[odds ratio (OR)=0.09, 95% confidence interval (CI)=0.02∼0.36, p<0.001], type A dissection (OR=8.26, 95% CI=3.44∼19.60, p<0.001), probable extravasation (pericardial effusion in type A dissection or left side pleural effusion in patients with involvement of descending thoracic aorta)(OR=2.70, 95% CI=1.14∼6.41, p=0.024), visible intimal flap in ascending aorta in trans-thoracic echocardiography(OR=4.46, 95% CI=1.58∼12.60, p=0.005), and acute renal deterioration(OR=3.85, 95% CI=1.36∼10.87, p=0.011). Conclusions: If acute aortic dissection, especially type A, is with high mortality in southern Taiwan. There are five independent predictors of in-hospital mortality found in current analysis. Our result may remind doctors to find out their patients at high risk. Trans-thoracic echocardiography is a useful tool to find out patients at high risk because it is easily performed to check if there is pericardial effusion or visible intimal flap in ascending aorta.

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