- Oral presentation
- Open Access
Evaluation of risk factors for mortality and long-term survival after repair of acute type-A aortic dissection in 836 patients
© Tutkun et al; licensee BioMed Central Ltd. 2013
- Published: 11 September 2013
- Logistic Regression
- Logistic Regression Model
- Operating Room
- Cardiac Arrest
- Predictive Factor
This study was designed to explore predictive factors for mortality and long-term survival in patients with acute type-A aortic dissection. We retrospectively assessed our data over a 15-year period starting in 1996.
Between 01/1996 and 09/2011, 836 patients (559 men) with a mean age of 59.6±13.6 (range 18-92) years underwent surgery for acute type-A aortic dissection. No patients were excluded from immediate operation irrespective of age and preoperative status unless uncontrollable hemorrhage and/or cardiac arrest occurred before the patient reached the operating room. Ninety-two perioperative variables were statistically analyzed to identify predictors for early mortality.
The overall 30-day mortality was 22.3% (without cardiogenic shock 18.4%). The mortality rate was 9.8 % in patients aged < 45 years and 34.6 % in older patients aged ≥ 80 years. In the last 5 years the overall mortality was reduced to 17.7 % (without cardiogenic shock 15.3%). A multivariable logistic regression model showed that age >60 years (OR 1.03, 95%CI, 1.01 to 1.04, P<0.001), preoperative high inotropic score (OR 1.9, 95% CI 1.1 to 3.0, P<0.001), and additional CABG (OR 2.6, 95% CI 1.6 to 4.1, P<0.001) were predictors of 30-day mortality.
The long-term survival and freedom from reoperation at 1, 5 and 10 years were 70.5%, 58.5%, 42.1% and 96.4%, 91.2%, 88.8%, respectively.
The results of this study support our institutional policy for acute type-A aortic dissection of not excluding any patients from the operation regardless of preoperative status and age.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.