Early and Late Mortality Predictors in Patients with Acute Aortic Dissection Type B

Ratko M Lasica; Jovan P Perunicic; Dejana R Popovic; Igor B Mrdovic; Ross A Arena; Nebojsa L Radovanovic; Mina R Radosavljevic-Radovanovic; Lazar D Djukanovic; Milika R Asanin

doi:10.1155/2022/7869356

Early and Late Mortality Predictors in Patients with Acute Aortic Dissection Type B

Cardiol Res Pract. 2022 Nov 26:2022:7869356. doi: 10.1155/2022/7869356. eCollection 2022.

Authors

Ratko M Lasica¹, Jovan P Perunicic¹, Dejana R Popovic², Igor B Mrdovic¹, Ross A Arena³, Nebojsa L Radovanovic¹, Mina R Radosavljevic-Radovanovic¹, Lazar D Djukanovic¹, Milika R Asanin¹

Affiliations

¹ Emergency Hospital, University Clinical Center Serbia, Pasterova 2, Belgrade 11000, Serbia.
² Division of Cardiology, University Clinical Center Serbia, Visegradska 26, Belgrade 11000, Serbia.
³ Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, 1200W Harrison St, Chicago, IL 60607, USA.

Abstract

Background/aim: Despite technological advances in diagnosis and treatment, in-hospital mortality with acute aortic dissection type B is still about 11%. The purpose of this study was to assess the risk factors for early and long-term adverse outcomes in patients with acute aortic dissection type B treated medically or with conventional open surgery.

Methods: The present study included 104 consecutive patients with acute aortic dissection type B treated in our Center from January 1^st, 1998 to January 1^st, 2007. Patient demographic and clinical characteristics as well as in-hospital complications were reviewed. Univariate and multivariate testing was performed to identify the predictors of in-hospital (30-day) and late (within 9 years) mortality.

Results: 92 (88.5%) patients were treated medically, while 12 (11.5%) patients with complicated acute aortic dissection type B were treated by open surgical repair. In-hospital complications occurred in 35.7% patients, the most often being acute renal failure (28%), hypotension/shock (24%), mesenteric ischemia (12%), and limb ischemia (8%). The in-hospital mortality rate was 15.7% and the 9-year mortality rate was 51.9%. Independent predictors of early mortality in patients with acute aortic dissection type B were uncontrolled hypertension (HR-20.69) and a dissecting aorta diameter >4.75 cm (HR-6.30). Independent predictors of late mortality were relapsing pain (HR-7.93), uncontrolled hypertension (HR-7.25), and a pathologic difference in arterial blood pressure (>20 mmHg) (HR-5.33).

Conclusion: Knowledge of key risk factors may help with a better choice of treatment and mortality reduction in acute aortic dissection type B patients.