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Is fibrinogen plasma level a risk factor for the first 24-hour death of medically treated acute type A aortic dissection patients?

BACKGROUND: The present study aims to assess the risk factors which affect the first 24-hour death of medical treatment in acute type A aortic dissection (ATAAD) patients. METHODS: This is a retrospective cohort study in a single center. From January 2009 to January 2018, 2,379 patients with type A...

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Autores principales: Yang, Sheng, Xue, Yuan, Liu, Jie, Zhang, Hongjia, Jiang, Wenjian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7475496/
https://www.ncbi.nlm.nih.gov/pubmed/32953815
http://dx.doi.org/10.21037/atm-20-5466
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author Yang, Sheng
Xue, Yuan
Liu, Jie
Zhang, Hongjia
Jiang, Wenjian
author_facet Yang, Sheng
Xue, Yuan
Liu, Jie
Zhang, Hongjia
Jiang, Wenjian
author_sort Yang, Sheng
collection PubMed
description BACKGROUND: The present study aims to assess the risk factors which affect the first 24-hour death of medical treatment in acute type A aortic dissection (ATAAD) patients. METHODS: This is a retrospective cohort study in a single center. From January 2009 to January 2018, 2,379 patients with type A aortic dissection were admitted to Beijing Anzhen Hospital, of which 243 patients who received medical intervention in ATAAD were involved in the final analysis. Fibrinogen plasma was obtained within 6 hours of admission and was assessed by using thrombin to convert fibrinogen to fibrin. Multivariable regressions were used to analyze the association of fibrinogen on in-hospital mortality and the first 24-hour mortality. RESULTS: The total in-hospital mortality rate was 92 (37.9%) in patients with ATAAD, and 33 (13.6%) of patients died within 24 hours of onset. We found no significant association between fibrinogen plasma level and in-hospital death (HR, 0.91; 95% CI, 0.78, 1.06; P=0.23), but a fibrinogen plasma level of ≤4.0 g/L was an independent risk factor for the first 24-hour mortality (HR, 5.92; 95% CI, 1.40, 25.08, P=0.02). CONCLUSIONS: ATAAD patients with a fibrinogen plasma level of >4.0 g/L have lower first 24-hour mortality when treated medically, while patients with a fibrinogen plasma level of ≤4.0 g/L are more likely to die without surgery in the first 24 hours.
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spelling pubmed-74754962020-09-17 Is fibrinogen plasma level a risk factor for the first 24-hour death of medically treated acute type A aortic dissection patients? Yang, Sheng Xue, Yuan Liu, Jie Zhang, Hongjia Jiang, Wenjian Ann Transl Med Original Article BACKGROUND: The present study aims to assess the risk factors which affect the first 24-hour death of medical treatment in acute type A aortic dissection (ATAAD) patients. METHODS: This is a retrospective cohort study in a single center. From January 2009 to January 2018, 2,379 patients with type A aortic dissection were admitted to Beijing Anzhen Hospital, of which 243 patients who received medical intervention in ATAAD were involved in the final analysis. Fibrinogen plasma was obtained within 6 hours of admission and was assessed by using thrombin to convert fibrinogen to fibrin. Multivariable regressions were used to analyze the association of fibrinogen on in-hospital mortality and the first 24-hour mortality. RESULTS: The total in-hospital mortality rate was 92 (37.9%) in patients with ATAAD, and 33 (13.6%) of patients died within 24 hours of onset. We found no significant association between fibrinogen plasma level and in-hospital death (HR, 0.91; 95% CI, 0.78, 1.06; P=0.23), but a fibrinogen plasma level of ≤4.0 g/L was an independent risk factor for the first 24-hour mortality (HR, 5.92; 95% CI, 1.40, 25.08, P=0.02). CONCLUSIONS: ATAAD patients with a fibrinogen plasma level of >4.0 g/L have lower first 24-hour mortality when treated medically, while patients with a fibrinogen plasma level of ≤4.0 g/L are more likely to die without surgery in the first 24 hours. AME Publishing Company 2020-08 /pmc/articles/PMC7475496/ /pubmed/32953815 http://dx.doi.org/10.21037/atm-20-5466 Text en 2020 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Yang, Sheng
Xue, Yuan
Liu, Jie
Zhang, Hongjia
Jiang, Wenjian
Is fibrinogen plasma level a risk factor for the first 24-hour death of medically treated acute type A aortic dissection patients?
title Is fibrinogen plasma level a risk factor for the first 24-hour death of medically treated acute type A aortic dissection patients?
title_full Is fibrinogen plasma level a risk factor for the first 24-hour death of medically treated acute type A aortic dissection patients?
title_fullStr Is fibrinogen plasma level a risk factor for the first 24-hour death of medically treated acute type A aortic dissection patients?
title_full_unstemmed Is fibrinogen plasma level a risk factor for the first 24-hour death of medically treated acute type A aortic dissection patients?
title_short Is fibrinogen plasma level a risk factor for the first 24-hour death of medically treated acute type A aortic dissection patients?
title_sort is fibrinogen plasma level a risk factor for the first 24-hour death of medically treated acute type a aortic dissection patients?
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7475496/
https://www.ncbi.nlm.nih.gov/pubmed/32953815
http://dx.doi.org/10.21037/atm-20-5466
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