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Risk factors for in-hospital death in 2,179 patients with acute aortic dissection

BACKGROUND: This study aims to investigate the risk factors for in-hospital death in patients with acute aortic dissection (AAD) and to provide a straightforward prediction model to assist clinicians in determining the outcome of AAD patients. METHODS: Retrospective analysis was carried out on 2,179...

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Autores principales: Yuan, Yue, Xia, Zhiyu, Wang, Lei, Sun, Qi, Wang, Wendan, Chai, Chen, Wang, Tiantian, Zhang, Xiaowei, Wu, Long, Tang, Zehai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166791/
https://www.ncbi.nlm.nih.gov/pubmed/37180780
http://dx.doi.org/10.3389/fcvm.2023.1159475
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author Yuan, Yue
Xia, Zhiyu
Wang, Lei
Sun, Qi
Wang, Wendan
Chai, Chen
Wang, Tiantian
Zhang, Xiaowei
Wu, Long
Tang, Zehai
author_facet Yuan, Yue
Xia, Zhiyu
Wang, Lei
Sun, Qi
Wang, Wendan
Chai, Chen
Wang, Tiantian
Zhang, Xiaowei
Wu, Long
Tang, Zehai
author_sort Yuan, Yue
collection PubMed
description BACKGROUND: This study aims to investigate the risk factors for in-hospital death in patients with acute aortic dissection (AAD) and to provide a straightforward prediction model to assist clinicians in determining the outcome of AAD patients. METHODS: Retrospective analysis was carried out on 2,179 patients admitted for AAD from March 5, 1999 to April 20, 2018 in Wuhan Union Hospital, China. The risk factors were investigated with univariate and multivariable logistic regression analysis. RESULTS: The patients were divided into two groups: Group A, 953patients (43.7%) with type A AAD; Group B, 1,226 patients (56.3%) with type B AAD. The overall in-hospital mortality rate was 20.3% (194/953) and 4% (50/1,226) in Group A and B respectively. The multivariable analysis included the variables that were statistically significant predictors of in-hospital death (P < 0.05). In Group A, hypotension (OR = 2.01, P = 0.001) and liver dysfunction (OR = 12.95, P < 0.001) were independent risk factors. Tachycardia (OR = 6.08, P < 0.001) and liver dysfunction (OR = 6.36, P < 0.05) were independent risk factors for Group B mortality. The risk factors of Group A were assigned a score equal to their coefficients, and the score of −0.5 was the best point of the risk prediction model. Based on this analysis, we derived a predictive model to help clinicians determine the prognosis of type A AAD patients. CONCLUSIONS: This study investigate the independent factors associated with in-hospital death in patients with type A or B aortic dissection, respectively. In addition, we develop the prediction of the prognosis for type A patients and assist clinicians in choosing treatment strategies.
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spelling pubmed-101667912023-05-10 Risk factors for in-hospital death in 2,179 patients with acute aortic dissection Yuan, Yue Xia, Zhiyu Wang, Lei Sun, Qi Wang, Wendan Chai, Chen Wang, Tiantian Zhang, Xiaowei Wu, Long Tang, Zehai Front Cardiovasc Med Cardiovascular Medicine BACKGROUND: This study aims to investigate the risk factors for in-hospital death in patients with acute aortic dissection (AAD) and to provide a straightforward prediction model to assist clinicians in determining the outcome of AAD patients. METHODS: Retrospective analysis was carried out on 2,179 patients admitted for AAD from March 5, 1999 to April 20, 2018 in Wuhan Union Hospital, China. The risk factors were investigated with univariate and multivariable logistic regression analysis. RESULTS: The patients were divided into two groups: Group A, 953patients (43.7%) with type A AAD; Group B, 1,226 patients (56.3%) with type B AAD. The overall in-hospital mortality rate was 20.3% (194/953) and 4% (50/1,226) in Group A and B respectively. The multivariable analysis included the variables that were statistically significant predictors of in-hospital death (P < 0.05). In Group A, hypotension (OR = 2.01, P = 0.001) and liver dysfunction (OR = 12.95, P < 0.001) were independent risk factors. Tachycardia (OR = 6.08, P < 0.001) and liver dysfunction (OR = 6.36, P < 0.05) were independent risk factors for Group B mortality. The risk factors of Group A were assigned a score equal to their coefficients, and the score of −0.5 was the best point of the risk prediction model. Based on this analysis, we derived a predictive model to help clinicians determine the prognosis of type A AAD patients. CONCLUSIONS: This study investigate the independent factors associated with in-hospital death in patients with type A or B aortic dissection, respectively. In addition, we develop the prediction of the prognosis for type A patients and assist clinicians in choosing treatment strategies. Frontiers Media S.A. 2023-04-25 /pmc/articles/PMC10166791/ /pubmed/37180780 http://dx.doi.org/10.3389/fcvm.2023.1159475 Text en © 2023 Yuan, Xia, Wang, Sun, Wang, Chai, Wang, Zhang, Wu and Tang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Yuan, Yue
Xia, Zhiyu
Wang, Lei
Sun, Qi
Wang, Wendan
Chai, Chen
Wang, Tiantian
Zhang, Xiaowei
Wu, Long
Tang, Zehai
Risk factors for in-hospital death in 2,179 patients with acute aortic dissection
title Risk factors for in-hospital death in 2,179 patients with acute aortic dissection
title_full Risk factors for in-hospital death in 2,179 patients with acute aortic dissection
title_fullStr Risk factors for in-hospital death in 2,179 patients with acute aortic dissection
title_full_unstemmed Risk factors for in-hospital death in 2,179 patients with acute aortic dissection
title_short Risk factors for in-hospital death in 2,179 patients with acute aortic dissection
title_sort risk factors for in-hospital death in 2,179 patients with acute aortic dissection
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166791/
https://www.ncbi.nlm.nih.gov/pubmed/37180780
http://dx.doi.org/10.3389/fcvm.2023.1159475
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