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Epidemiology and long-term prognostic factors in acute type B aortic dissection
S Acosta1, D Blomstrand, A Gottsäter
1Department of Vascular Diseases, Malmö University Hospital, S-205 02 Malmö, Sweden. stefan.acosta@telia.com
Annals of Vascular Surgery
|May 22, 2007
Summary
Long-term mortality in acute type B aortic dissection is predicted by renal insufficiency and coexistent aortic disease. Endovascular intervention showed no impact on short- or long-term survival.
Area of Science:
- Cardiovascular Research
- Epidemiology
- Medical Interventions
Background:
- Limited epidemiological data exists on long-term mortality predictors for acute type B aortic dissection (AD).
- Understanding risk factors is crucial for managing this serious cardiovascular condition.
Purpose of the Study:
- To identify long-term mortality predictors in patients with acute type B AD.
- To evaluate the impact of endovascular intervention on survival rates.
Main Methods:
- Retrospective analysis of 72 patients with acute type B AD (2000-2004) from a Swedish hospital registry.
- Multivariate logistic regression analysis to determine independent predictors of long-term mortality.
- Incidence rates calculated per 100,000 person-years.
Main Results:
- Shock due to rupture was linked to in-hospital mortality (P=0.006).
- Renal insufficiency (OR=4.7) and coexistent aortic disease (OR=4.1) were independent predictors for long-term mortality.
- Endovascular intervention (n=32) did not affect short- or long-term mortality.
Conclusions:
- Renal insufficiency and coexistent aortic disease are significant predictors of long-term mortality in acute type B AD.
- Endovascular treatment appears to have a neutral effect on survival compared to medical management.
- Overall incidence of acute type B AD was 2.1/100,000 person-years, with higher rates in older adults.
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