Clinical profiles and outcomes of acute type A aortic dissection and intramural hematoma in the current era: lessons from the first registry of aortic dissection in China.
10.1097/CM9.0000000000001459
- Author:
Wei-Xun DUAN
1
;
Wei-Guang WANG
2
;
Lin XIA
1
;
Chao XUE
1
;
Bo YU
1
;
Kai REN
1
;
Wei YI
1
;
Hong-Liang LIANG
1
;
Xiao-Chao DONG
1
;
Jian ZUO
1
;
Jin-Cheng LIU
1
;
Shi-Qiang YU
1
;
Ding-Hua YI
1
Author Information
1. Department of Cardiovascular Surgery, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi 710032, China.
2. 71901 troops, The Chinese People's Liberation Army, Liaocheng, Shandong 252000, China.
- Collective Name:Registry of Aortic Dissection in China (Sino-RAD) investigators
- Publication Type:Journal Article
- MeSH:
Acute Disease;
Aneurysm, Dissecting/diagnosis*;
China;
Hematoma;
Humans;
Male;
Middle Aged;
Registries;
Retrospective Studies;
Time Factors;
Treatment Outcome
- From:
Chinese Medical Journal
2021;134(8):927-934
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Acute type A aortic dissection (ATAAD) and acute type A intramural hematoma (ATAIMH) are life-threatening diseases with high mortality. To better understand their clinical features in the Chinese population, we analyzed the data from the first Registry of Aortic Dissection in China (Sino-RAD) to promote the understanding and management of the diseases.
METHODS:All patients with ATAAD and ATAIMH enrolled in Sino-RAD from January 1, 2012 to December 31, 2016 were involved. The data of patients' selection, history, symptoms, management, outcomes, and postoperation complications were analyzed in the study. The continuous variables were compared using the Student's t test for normal distributions and the Mann-Whitney U test for non-normal distributions. Categorical variables were compared using the Chi-square test or Fisher exact test.
RESULTS:A total of 1582 patients with ATAAD and 130 patients with ATAIMH were included. The mean age of all patients was 48.4 years. Patients with ATAAD were significantly younger than patients with ATAIMH (48.9 years vs. 55.6 years, P < 0.001). For the total cohort, males were dominant, but the male ratio of patients with ATAAD was significantly higher compared to those with ATAIMH (P = 0.01). The time range from the onset of symptom to hospitalization was 2.0 days. More patients of ATAIMH had hypertension than that of ATAAD (82.3% vs. 67.6%, P < 0.05). Chest and back pain were the most common clinical symptoms. Computerized tomography (CT) was the most common initial diagnostic imaging modality. 84.7% received surgical treatment and in-hospital mortality was 5.3%. Patients with ATAAD mainly received surgical treatment (89.6%), while most patients with ATAIMH received medical treatment (39.2%) or endovascular repair (35.4%).
CONCLUSIONS:Our study suggests that doctors should comprehensively use clinical examination and genetic background screening for patients with ATAAD and ATAIMH and further shorten the time range from symptoms onset to intervention, achieving early diagnosis and treatment, thereby reducing the mortality rate of patients with aortic dissection in China. We should standardize the procedures of aortic dissection treatment and improve people's understanding. Meanwhile, the curing and transferring efficiency should also be improved.
