[Incidence and mortality of aortic dissection]

A population-based study was carried out over a 24-year period between January 1, 1973 and December 31, 1996 to determine the incidence and mortality of the aortic dissection in an administratively defined population of 106,000 inhabitants. The study comprises the consecutive cases of both inpatients and outpatients. Altogether, 74 cases of aortic dissection were found corresponding to 2.89%/year incidence. From the 74 patients 60 were admitted to hospital and 14 outpatients dead before the admission. In the first half of the observational interval (1973-84) 32 cases and in it's second half (1985-96) 42 cases were occurred with incidence of 2.50%/year and 3.28%/year, respectively. The higher incidence of the cases in the second half interval was explained by the significant increase of the autopsy rate of the dead outpatients. The male/female ratio was 1:1.6. The age ranged from 36 years to 97 years with a mean of 66.4 years and the women have had higher mean by the 7.0 years (p < 0.05). The mortality was explosively abrupt at the onset of the disease. Fourteen outpatients (18.9% of the total) died suddenly before admission and in the inpatients after the admission 28.4% died within the first hour, 44.6% within 12 hours, 62.2% within 24 hours and 75.5% within the first two days. Six patients were surgically treated and their perioperative mortality was 2/6, one month survived 4/6 and three years survived 3/6. The other 71 patients died. On the bases of the above-mentioned facts this work may be considered as an representative study. Hereby, the incidence of the aortic dissection in Hungary at least 3.0/100,000/year or rather 300 cases/year should be assessed.