Objective In order to gain more insight into the situation we investigated predictors of in-hospital mortality of surgically or medicines treated type A aortic dissection patients and assessed two-year survival.
Method 131 consecutive patients undergoing surgery or drug therapy for type A aortic dissection in a 6-year period (2005–2011) were evaluated. Preoperative and intraoperative variables were analysed to identify predictors of early mortality. Between the case fatality ratio of clinical linear relationship, using Cox regression analysis.
Result The characteristics and follow-up outcomes were compared between the groups or subgroups. 131 patients have Stanford A aortic dissection, 41 patients have Aorta sandwich separation. Marfan syndrome was present in five patients and four patients had a bicuspid aortic valve. In-hospital mortality was 33.6%. Effect factors of in hospital mortality for patients with type A AD included stay in hospital time, gender, type A grade, therapy, use ACEI drugs, use beta blocker drugs, use CCB drugs; Multifactor COX regression revealed stay in hospital time, (risk ratio RR = 0.828; 95%Confidence interval CI (0.764.0.896), P = 0.000); the length of ICU stay (RR = 1.204; 95%Confidence interval CI (1.085.1.336), P = 0.000); gender (RR = 0.287; 95%Confidence interval CI (0.114.0.680), P = 0.005), symptom (RR = 0.695; 95%Confidence interval CI (0.569.0.850), P = 0.000); use beta blockers (RR = 0.338; 95%Confidence interval CI (0.177.0.643), P = 0.001); to be the only independent predictor of in-hospital mortality. Two-year survival was (60/131, 54.2%)(including hospital mortality).
Conclusions The grade and therapy of type A aortic dissection Obvious influence short-term and long-term results (fig1.2). Chronic type A aortic dissection have lower in hospital mortality compare to acute aortic dissection (fig 3), and be surgery patients have had higher survival rate than people with medical therapy (fig 4). We need long-term, large sample data to predict type A aortic dissection in the hospital death and long-term survival risk factors.