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Factors Associated with Early Mortality in Acute Type A Aortic Dissection-A Single-Centre Experience
Panagiotis Doukas1, Nicola Dalibor1, András Keszei2
1European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, RWTH University Hospital Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
Journal of Clinical Medicine
|February 24, 2024
Summary
Identifying risk factors for mortality in acute aortic dissection type A (AADA) is crucial. Postoperative focal neurological deficits are the strongest predictor of fatal outcomes in AADA patients.
Area of Science:
- Cardiology
- Thoracic Surgery
- Vascular Surgery
Background:
- Acute aortic dissection type A (AADA) presents significant mortality and morbidity risks.
- Identifying patients at risk and understanding mortality factors are critical for improving outcomes.
Purpose of the Study:
- To analyze preoperative, intraoperative, and postoperative variables associated with in-hospital mortality in AADA patients.
- To identify key predictors of fatal outcomes in AADA.
Main Methods:
- Retrospective observational study of 117 AADA patients operated between 2005 and 2021.
- Analysis of preoperative, intraoperative, and postoperative data correlated with in-hospital mortality.
Main Results:
- Overall survival rate was 83%.
- Preoperative mortality factors included age, hypertension, aortic valve stenosis, atrial fibrillation, and oral anticoagulation.
- Postoperative mortality strongly correlated with acute kidney injury, heart failure, stroke, neurological deficits, and sepsis. Focal neurological deficits were the best predictor of fatal outcomes (OR: 5.8).
Conclusions:
- Age, hypertension, atrial fibrillation, and oral anticoagulation are linked to AADA mortality.
- Postoperative acute kidney injury, heart failure, sepsis, and focal neurological deficits predict mortality.
- Early detection and interdisciplinary management of at-risk patients are vital postoperatively.
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