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Incidence Rates of Penn Classes and Class-Specific Mortality in Acute Type A Aortic Dissection Patients: An
Ashwini Chandiramani1, Mohammed Al-Tawil2, Tharun Rajasekar3
1Department of Cardiac Surgery, St. Thomas' Hospital, London, United Kingdom.
Journal of Cardiothoracic and Vascular Anesthesia
|April 21, 2024
Summary
Acute type A aortic dissection (ATAAD) classification by Penn system shows increasing mortality with higher classes. Penn C and BC present the highest risks, highlighting the system's prognostic value for this emergency.
Area of Science:
- Cardiovascular Surgery
- Medical Diagnostics
- Clinical Research
Background:
- Acute type A aortic dissection (ATAAD) is a critical surgical emergency.
- End-organ ischemia is a significant predictor of mortality in ATAAD.
- The Penn classification system aids in stratifying ATAAD risk.
Purpose of the Study:
- To evaluate the utility of the Penn classification system in observational studies of ATAAD.
- To analyze incidence rates and mortality patterns across different Penn classes.
- To assess the prognostic value of the Penn classification in ATAAD patients.
Main Methods:
- A meta-analysis of observational studies was conducted.
- Searches were performed in PubMed, MEDLINE, and Embase up to April 2023.
- Data from 10 studies involving 4,494 patients were analyzed.
Main Results:
- The pooled incidence was highest for Penn A (0.55), followed by Penn B (0.21), and Penn C (0.14).
- Patients with Penn BC had the highest early mortality rate (0.36).
- Individual mortality rates increased with Penn class: Penn C (0.21), Penn B (0.19), and Penn A (0.07).
Conclusions:
- The Penn classification system effectively stratifies risk in ATAAD.
- Higher Penn classification grades correlate with increased mortality.
- The system aids in understanding prognostic outcomes in ATAAD patients.
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