title: Penn classification in acute aortic dissection patients.
abstract: OBJECTIVE
  The objective of this study was to evaluate the effectiveness of the Penn classification in predicting in-hospital mortality after surgery in acute type A aortic dissection patients.
  
  
  METHODS
  We evaluated 58 patients (42 men and 16 women; mean age 62.17 ± 10.6 years) who underwent emergency surgery for acute type A aortic dissection between September 2003 and June 2010 in our department. We investigated the correlation between the pre-operative malperfusion and in-hospital outcome after surgery.
  
  
  RESULTS
  Twenty-eight patients (48%) were Penn class Aa (absence of branch vessel malperfusion or circulatory collapse), 11 (19%) were Penn class Ab (branch vessel malperfusion with ischaemia), 5 (9%) were Penn class Ac (circulatory collapse with or without cardiac involvement) and 14 (24%) were Penn class Abc (both branch vessel malperfusion and circulatory collapse). The number of patients with localized or generalized ischaemia or both, Penn class non-Aa, was 30 (52%). In-hospital mortality was 24%. In-hospital mortality was significantly higher in Penn class Abc and Penn class non-Aa. Intensive unit care stay, hospital ward stay and overall hospital stay was longer in Penn class non-Aa vs Penn class Aa. De Bakey type I dissection and type II diabetes mellitus were associated with in-hospital mortality.
  
  
  CONCLUSIONS
  Preoperative malperfusion is important for the evaluation of patients with acute aortic type A dissection. The Penn classification is a simple and quick method to apply and predict in-hospital mortality and outcomes.
authors.forename: Calogera
authors.initials: C
authors.lastname: Pisano
authors.forename: Carmela Rita
authors.initials: CR
authors.lastname: Balistreri
authors.forename: Federico
authors.initials: F
authors.lastname: Torretta
authors.forename: Veronica
authors.initials: V
authors.lastname: Capuccio
authors.forename: Alberto
authors.initials: A
authors.lastname: Allegra
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Argano
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ruvolo
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000145:classification / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D001014:Aortic Aneurysm / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000209:etiology; D017063:Outcome Assessment, Health Care; D011300:Preoperative Care / Q000379:methods*; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods; D012769:Shock / Q000175:diagnosis* / Q000209:etiology; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods
keywords: DeBakey classification; Penn classification; Stanford classification; Type A dissection