title: [Predictors of peri-operative mortality in patients with aortic dissection].
abstract: OBJECTIVE
  To analyze the peri-operative risk factors of mortality in patients with aortic dissection (AD).
  
  
  METHODS
  Between January 2003 and June 2008, 361 AD patients at our hospital were enrolled. Their demographics, history, clinical characteristics and laboratory examinations were retrospectively analyzed. Twenty pre-operative variables were analyzed to identify the predictors of perioperative mortality of AD patients by the analyses of univariate and multivariate logistic regression.
  
  
  RESULTS
  The analysis of univariate logistic regression showed that history of hypertension [odds ratio (OR) 0.465, 95% confidence interval (CI) 0.229 - 0.947, P = 0.035], Stanford type A (OR 2.758, 95%CI 1.054 - 7.213 P = 0.039), acute course (OR 7.897, 95%CI 1.874 - 33.275 P = 0.005), neurological symptoms (OR 0.275, 95%CI 0.140 - 0.541, P < 0.001) and operation or not (OR 8.206, 95%CI 4.205 - 16.012, P < 0.001) had a higher mortality in AD patients. The multivariate analysis revealed that acute course (OR 8.178, 95%CI 1.796 - 37.242, P = 0.007), Stanford type A (OR 3.236, 95%CI 1.104-9.487 P = 0.032), neurological symptoms (OR 0.350, 95%CI 0.159 - 0.770, P = 0.009) and operation or not (OR 9.429, 95%CI 4.456 - 19.952, P < 0.001) were significant independent predictors of perioperative mortality in AD patients.
  
  
  CONCLUSIONS
  History of hypertension, acute course, Stanford A and positive neurological symptoms are the independent predictors of perioperative mortality in AD patients. Operation or not is a determinant of patient outcome.
authors.affiliation: Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Shen
authors.forename: Chen-ling
authors.initials: CL
authors.lastname: Yao
authors.forename: Zhen-gang
authors.initials: ZG
authors.lastname: Tao
authors.forename: Bai-shun
authors.initials: BS
authors.lastname: Xi
authors.forename: Xiao
authors.initials: X
authors.lastname: Lun
authors.forename: Dong-wei
authors.initials: DW
authors.lastname: Shi
authors.forename: Zhan
authors.initials: Z
authors.lastname: Sun
authors.forename: Chao-yang
authors.initials: CY
authors.lastname: Tong
authors.forename: Lai
authors.initials: L
authors.lastname: Wei
authors.forename: Chun-sheng
authors.initials: CS
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000401:mortality* / Q000601:surgery; D001014:Aortic Aneurysm / Q000401:mortality* / Q000601:surgery; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult