title: Outcome Predictors in Patients Presenting With Acute Aortic Dissection.
abstract: OBJECTIVE
  To investigate the role of thyroid hormones and other factors in acute aortic dissection and an association with in-hospital adverse events.
  
  
  METHODS
  A retrospective analysis.
  
  
  METHODS
  A university-affiliated cardiac center.
  
  
  METHODS
  A total of 151 patients with aortic dissection admitted to the authors' hospital between January 2011 and May 2015.
  
  
  METHODS
  None.
  
  
  RESULTS
  The total in-hospital mortality rate was 12.6%. Triiodothyronine (T3) level was lower in nonsurviving than surviving patients (0.8±0.3 v 1.0±0.4 nmol/L, p<0.05). T3 independently predicted in-hospital mortality (hazard ratio [HR] 0.07, 95% CI 0.01-0.43, p<0.01) and in-hospital acute renal failure (HR 0.22, 0.05-0.89, p<0.05) for all patients. Other independent predictors of in-hospital mortality were pericardial effusion (HR 8.18, 2.11-31.67, p<0.01), conservative treatment (HR 82.12, 12.49-540.09, p<0.01) and Stanford type-A aortic dissection (HR 3.86, 1.06-14.09, p<0.05). Inpatient conservative treatment, T3 (HR 0.01, 0.00-0.18, p<0.01) as well as pericardial effusion (HR 11.80, 2.46-56.59, p<0.01), Stanford type-A dissection (HR 22.35, 3.15-158.40, p<0.01), and in-hospital acute renal failure (HR 16.95, 2.04-140.86, p<0.01) were predictors for in-hospital mortality. In nonconservatively treated patients, T3 (HR 0.02, 0.00-0.88, p<0.05) as well as cardiac care unit stay (HR 0.74, 0.59-0.94, p<0.01) and postoperative acute renal failure (HR 21.32, 3.07-147.88, p<0.01) were predictors for in-hospital mortality.
  
  
  CONCLUSIONS
  T3 was downregulated in acute aortic dissection. Low T3 level was a risk factor for in-hospital death and acute renal failure in patients with acute aortic dissection.
authors.affiliation: Department of Clinical Laboratory, Wenzhou Central Hospital, Wenzhou, Zhejiang Province, China;
authors.forename: Chen
authors.initials: C
authors.lastname: Lingzhi
authors.affiliation: Cardiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
authors.forename: Zhou
authors.initials: Z
authors.lastname: Hao
authors.affiliation: Cardiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
authors.forename: Huang
authors.initials: H
authors.lastname: Weijian
authors.affiliation: Cardiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Gaoshu
authors.affiliation: Thoracic Surgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
authors.forename: Sun
authors.initials: S
authors.lastname: Chengchao
authors.affiliation: Cardiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Changxi
authors.affiliation: Cardiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
authors.forename: Zhao
authors.initials: Z
authors.lastname: Chuhuan
authors.affiliation: Cardiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China. Electronic address: lyonx@126.com.
authors.forename: Gao
authors.initials: G
authors.lastname: Zhan
mesh_terms: D000208:Acute Disease; D058186:Acute Kidney Injury / Q000097:blood / Q000150:complications; D000784:Aortic Dissection / Q000097:blood* / Q000150:complications / Q000628:therapy*; D001014:Aortic Aneurysm / Q000097:blood* / Q000150:complications / Q000628:therapy*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000097:blood / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D013963:Thyroid Hormones / Q000097:blood*; D016896:Treatment Outcome
chemical_list: D013963:Thyroid Hormones
keywords: acute aortic dissection; acute renal failure; triiodothyronine