Objectives To observe the impact of admission blood pressure on in-hospital mortality in patients with aortic dissection
Methods The clinical data of 580 in-hospital patients with aortic dissection were divided into five groups according to the admission blood pressure: group A: 90-119/60-79 mmHg, group B: 120-139/80-90 mmHg, group C: 140-159/90-99 mmHg, group D: 160-179/100-109 mmHg and group E ≥180 mmHg. The cases of each group, treatment approaches and the cases of in-hospital were analysed. Among them, there were 198 cases of Stanford A type aortic dissection and 382 cases of Stanford B type aortic dissection.
Results Gender, smoking, hypertension, diabetes and drinking were not significantly differences among each group (p > 0.05). The proportion of patients who with type A aortic dissection and received surgical operation in group A were significantly increased compared with other groups (p < 0.01), however, the average age and admission heart rate in group A were significantly decreased compared with other groups (p < 0.01). The proportion of patients who with type B aortic dissection and admission pain were significantly increased in group D and E (p < 0.01). 87 patients died during hospitalisation (15%), in-hospital mortality was significantly higher in group A than other groups (p < 0.01). Except for group A, the in-hospital mortality wan lower than group B, group C and group D (p < 0.05), there were also significant differences among the last three groups (p < 0.05). According to the rise of the blood pressure, in-hospital mortality reduced.
Conclusions Patients with aortic dissection who had a relatively low admission blood pressure or had a relatively high admission blood pressure were predictors of the type of aortic dissection, patients who with high admission blood pressure had apparent symptoms at admission, and received treatment in time, the proportion of Stanford type B aortic dissection was higher and more patients received interventional therapy, and the in-hospital mortality reduced.