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Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study

BACKGROUND: Medical therapy is the standard treatment for uncomplicated acute type B aortic dissection (ATBAD), but there is little evidence of the need for intensive care unit (ICU) management. Therefore, we aimed to investigate the effects of ICU treatment on uncomplicated ATBAD. METHODS: We retro...

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Autores principales: Lee, Chul Ho, Jang, Jae Seok, Cho, Jun Woo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Journal of Yeungnam Medical Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9580059/
https://www.ncbi.nlm.nih.gov/pubmed/35139623
http://dx.doi.org/10.12701/jyms.2021.01690
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author Lee, Chul Ho
Jang, Jae Seok
Cho, Jun Woo
author_facet Lee, Chul Ho
Jang, Jae Seok
Cho, Jun Woo
author_sort Lee, Chul Ho
collection PubMed
description BACKGROUND: Medical therapy is the standard treatment for uncomplicated acute type B aortic dissection (ATBAD), but there is little evidence of the need for intensive care unit (ICU) management. Therefore, we aimed to investigate the effects of ICU treatment on uncomplicated ATBAD. METHODS: We retrospectively studied patients with uncomplicated ATBAD who were medically treated between January 2010 and July 2020. Patients were divided into short-term ICU stay (SIS) and long-term ICU stay (LIS) groups, according to a 48-hour cutoff of ICU stay duration. The incidence of pneumonia and delirium, rate of aortic events, hospital mortality, and survival rate were compared. RESULTS: Fifty-five patients were treated for uncomplicated ATBAD (n=29 for SIS and n=26 for LIS). The incidence of pneumonia (3.6% vs. 7.7%) and delirium (14.3% vs. 34.6%) was higher in the LIS group than in the SIS group, but the differences were not statistically significant. The survival rates at 1, 3, and 5 years were not different between the two groups (SIS: 96.4%, 92.2%, and 75.5% vs. LIS: 96.2%, 88.0%, and 54.2%, respectively; p=0.102). Multivariate Cox regression analysis for aortic events showed that using a calcium channel blocker lowered the risk of aortic events. CONCLUSION: Long-term ICU treatment is unlikely to be necessary for the treatment of uncomplicated ATBAD. Active use of antihypertensive agents, such as calcium channel blockers, may be needed during the follow-up period.
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spelling pubmed-95800592022-10-25 Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study Lee, Chul Ho Jang, Jae Seok Cho, Jun Woo J Yeungnam Med Sci Original Article BACKGROUND: Medical therapy is the standard treatment for uncomplicated acute type B aortic dissection (ATBAD), but there is little evidence of the need for intensive care unit (ICU) management. Therefore, we aimed to investigate the effects of ICU treatment on uncomplicated ATBAD. METHODS: We retrospectively studied patients with uncomplicated ATBAD who were medically treated between January 2010 and July 2020. Patients were divided into short-term ICU stay (SIS) and long-term ICU stay (LIS) groups, according to a 48-hour cutoff of ICU stay duration. The incidence of pneumonia and delirium, rate of aortic events, hospital mortality, and survival rate were compared. RESULTS: Fifty-five patients were treated for uncomplicated ATBAD (n=29 for SIS and n=26 for LIS). The incidence of pneumonia (3.6% vs. 7.7%) and delirium (14.3% vs. 34.6%) was higher in the LIS group than in the SIS group, but the differences were not statistically significant. The survival rates at 1, 3, and 5 years were not different between the two groups (SIS: 96.4%, 92.2%, and 75.5% vs. LIS: 96.2%, 88.0%, and 54.2%, respectively; p=0.102). Multivariate Cox regression analysis for aortic events showed that using a calcium channel blocker lowered the risk of aortic events. CONCLUSION: Long-term ICU treatment is unlikely to be necessary for the treatment of uncomplicated ATBAD. Active use of antihypertensive agents, such as calcium channel blockers, may be needed during the follow-up period. Journal of Yeungnam Medical Science 2022-02-10 /pmc/articles/PMC9580059/ /pubmed/35139623 http://dx.doi.org/10.12701/jyms.2021.01690 Text en Copyright © 2022 Yeungnam University College of Medicine, Yeungnam University Institute of Medical Science https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Lee, Chul Ho
Jang, Jae Seok
Cho, Jun Woo
Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study
title Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study
title_full Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study
title_fullStr Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study
title_full_unstemmed Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study
title_short Intensive care unit management of uncomplicated type B aortic dissection in relation to treatment period: a retrospective observational study
title_sort intensive care unit management of uncomplicated type b aortic dissection in relation to treatment period: a retrospective observational study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9580059/
https://www.ncbi.nlm.nih.gov/pubmed/35139623
http://dx.doi.org/10.12701/jyms.2021.01690
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