title: Prevalence of Type A Acute Aortic Dissection in Patients With Out-Of-Hospital Cardiopulmonary Arrest.
abstract: Postmortem computed tomography (PMCT) has been recently reported to be useful for detecting causes of death in the emergency department. In this study, the incidence and causes of death of type A acute aortic dissection (AAD) were investigated in patients who experienced out-of-hospital cardiopulmonary arrest (OHCPA) using PMCT. PMCT or enhanced computed tomography was performed in 311 of 528 consecutive patients experiencing OHCPA. A total of 23 (7%) of 311 patients were diagnosed with type A AAD based on clinical courses and CT findings. Eighteen consecutive patients who did not experience OHCPA were diagnosed with type A AAD during the same period. Pre-hospital death was observed in 21 (51%) of 41 patients with type A AAD. Bloody pericardial effusion was observed more frequently in patients who experienced OHCPA with type A AAD than in those who did not experience OHCPA with type A AAD (91% vs 28%, respectively; p <0.05). In conclusion, the incidence of type A AAD was common (7%) in patients who experienced OHCPA, with a high rate of pre-hospital death. Aortic rupture to the intrapericardial space was considered the major cause of death in patients who experienced OHCPA with type A AAD.
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Sakata
authors.affiliation: Division of Radiology, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Sakurai
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Yoshimuta
authors.affiliation: Division of Emergency and Critical Care Center, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Morishita
authors.affiliation: Division of Emergency and Critical Care Center, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nara
authors.affiliation: Division of Emergency and Critical Care Center, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Takahashi
authors.affiliation: Division of Cardiovascular Center, Teine Keijinkai Hospital, Sapporo, Japan.
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Hirokami
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan. Electronic address: myamagi@med.kanazawa-u.ac.jp.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
mesh_terms: D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed