[Analysis of death-related factors of type B aortic dissection treated medically during the acute phase].
OBJECTIVE
To analyze the death-related risk factors of type B aortic dissection treated medically during the acute phase (symptoms presenting within 14 d), and to determine the predictors of surgical indications for acute type B aortic dissection.


METHODS
Clinical data of 42 patients with acute type B aortic dissection admitted from January 2007 to May 2009 was retrospectively reviewed. There were 33 male and 9 female with a mean age of (50 +/- 12) years old. Therapy included analgesia, controlled hypotension and beta-receptor blocker, the mortality in acute phase was 33.3% (14/42). Univariate and multivariate logistic regression analyses were performed to identify the predictors of the death in acute phase.


RESULTS
In univariate logistic regression analysis, the malperfusion of aortic branches (P = 0.018) and maximum aortic diameter (P = 0.002) were significant predictors of death. In the multivariate logistic regression model, the malperfusion of aortic branches (P = 0.041) and maximum aortic diameter (P = 0.005) were also considered as the significant death-related factors.Risk of death augmented significantly (P = 0.000) when the maximum aortic diameter over 40 mm.


CONCLUSIONS
Malperfusion of aortic branches and the large maximum aortic diameter (> 40 mm) are the indications of surgery or endovascular therapy for acute type B aortic dissection.
Wang
Lei
L
Division of Vascular and Thyroid Surgery, Department of General Surgery, First Hospital of China Medical University, Shenyang, China.
Xin
Shi-jie
SJ
Xiao
Liang
L
Ren
Ling
L
Zhang
Jian
J
Hu
Hai-di
HD
Song
Qing-bin
QB
Hu
Xin-hua
XH
Zhang
Ping
P
Zhang
Zan-song
ZS
Yang
De-hua
DH
Wang
Chuan-jiang
CJ
Duan
Zhi-quan
ZQ
Xu
Ke
K
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000188:drug therapy / Q000401:mortality*; D001014:Aortic Aneurysm / Q000188:drug therapy / Q000401:mortality*; D002423:Cause of Death; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors