Determinants of In-Hospital Death and Rupture in Patients With a Stanford B Aortic Dissection
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概要
- 論文の詳細を見る
Background In Stanford B acute aortic dissection (AAD), medical treatment is the choice of therapy in the acute phase, however, a portion of patients experience complications caused by serious clinical outcomes including aortic rupture and abdominal visceral ischemia. The objective of this study was to determine the predictors of in-hospital events in an Asian cohort of Stanford type B AAD. Methods and Results Hospital records were queried to identify patients that met following criteria : (1) AAD presenting within 14 days of symptom onset ; and (2) computed tomography (CT) confirmation of a dissected de-scending aorta not involving the ascending aorta. An in-hospital event was defined as death, rupture/impending rupture, or organ malperfusion. Patient characteristics, inflammatory markers, and CT findings were obtained from clinical case records and retrospectively analyzed. Two hundred and twenty patients with Stanford B AAD were identified. In-hospital events occurred in 15 patients (there were 8 deaths, and 5 patients need to undergo emergent surgery because of impending rupture or rupture, and 4 patients experienced organ malperfusion). In univariate logistic regression analysis, the non-thrombosed type (odds ratio (OR) 3.88, 95% confidence interval (CI) 1.20-12.61, p=0.02) and maximum aortic diameter measured by an initial CT (each having a 5mm increment : OR 1.61, 95% CI 1.20-2.15, p=0.001) were significant predictors of in-hospital events. In multiple logistic regression analysis, the only significant predictor was maximum aortic diameter measured by an initial CT (each having a 5mm increment : OR 1.41, 95% CI 1.04-1.92, p=0.03). Conclusion The results identified a large maximum aortic diameter as the independent predictor of in-hospital events in Stanford type B AAD. The non-thrombosed type might also help differentiate high-risk patients.
- 社団法人日本循環器学会の論文
- 2007-09-20
著者
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Murata Seiichiro
Cardiovascular Division Jichi Medical University Saitama Medical Center
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Kubo Norifumi
Division of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center
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Ako Junya
Division of Cariovascular Medicine, Stanford University School of Medicine
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Yasu Takanori
Division of Cardiovascular Medicine, Jichi Medical School
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Yasu Takanori
First Department Of Integrated Medicine Saitama Medical Center Jichi Medical University
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Ako Junya
Cardiovascular Medicine Stanford University
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Ikeda Nahoko
First Department Of Integrated Medicine Saitama Medical Center Jichi Medical University
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Ikeda Nahoko
First Department Of Integrated Medicine Omiya Medical Center Jichi Medical University
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Kubo Norifumi
First Department Of Integrated Medicine Saitama Medical Center Jichi Medical University
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Yasu Takanori
Division Of Cardiovascular Medicine Department Of Integrated Medicine I Jichi Medical University Sai
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Yasu Takanori
Department Of Clinical Pharmacology & Therapeutics University Of The Ryukyus Graduate School Of
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Hirahara Taishi
Division Of Cardiovascular Medicine Department Of Integrated Medicine I Jichi Medical University Sai
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Kawakami M
First Department Of Integrated Medicine Saitama Medical Center Jichi Medical University
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Funayama Hiroshi
Division of Cardiology, Saitama Medical Center, Jichi Medical School
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Sugawara Yoshitaka
Division of Cardiology, Saitama Medical Center, Jichi Medical School
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Kawakami Masanobu
Division of Cardiology, Saitama Medical Center, Jichi Medical School
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Momomura Shinichi
Division of Cardiology, Saitama Medical Center, Jichi Medical School
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SAKAKURA Kenichi
Division of Cardiovascular Medicine, Department of Integrated Medicine I, Jichi Medical University S
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IKEDA Nahoko
Division of Cardiovascular Medicine, Department of Integrated Medicine I, Jichi Medical University S
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Sugawara Yoshitaka
First Department Of Integrated Medicine Saitama Medical Center Jichi Medical University
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Kawakami Masanobu
First Department Of Integrated Medicine Saitama Medical Center Jichi Medical University
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Kanda Masaru
Department Of Medicine Jichi Medical University Saitama Medical Center
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Kubo Norifumi
Division Of Cardiovascular Medicine Department Of Integrated Medicine I Jichi Medical University Sai
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Ako Junya
Division Of Cardiovascular Medicine Stanford University Medical Center
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Yasu Takanori
Division Of Cardiology Saitama Medical Center Jichi Medical School
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Sakakura Kenichi
Department Of Integrated Medicine 1 Cardiovascular Division Jichi Medical University Saitama Medical
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Kubo Norifumi
Cardiovascular Division Jichi Medical University Saitama Medical Center
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Funayama Hiroshi
Cardiovascular Division Jichi Medical University Saitama Medical Center
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Tada Yuuko
Division Of Cardiology Saitama Medical Center Jichi Medical School
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Yasu Takanori
Division Of Cardiovascular Medicine Department Of Integrated Medicine I Jichi Medical University Sai
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Tada Yuko
Cardiovascular Division Department Of Medicine Jichi Medical University Saitama Medical Center
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Kanda M
Department Of Surgical Neurology Jichi Medical School Omiya Medical Center
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Ikeda Nahoko
Division Of Cardiovascular Medicine Department Of Integrated Medicine I Saitama Medical Center Jichi Medical University
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Sakakura Kenichi
Division Of Cardiovascular Medicine Department Of Integrated Medicine I Saitama Medical Center Jichi Medical University
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Ako Junya
Division Of Cardiovascular Medicine Department Of Integrated Medicine I Saitama Medical Center Jichi Medical University
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Ikeda Nahoko
Division Of Cardiovascular Medicine Department Of Integrated Medicine I Jichi Medical University Saitama Medical Center
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Kubo Norifumi
Division of Cardiology, Department of Integrated Medicine I, Saitama Medical Center, Jichi Medical University School of Medicine
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Funayama Hiroshi
Division of Cardiology, Department of Integrated Medicine I, Saitama Medical Center, Jichi Medical University School of Medicine
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Sakakura Kenichi
Division of Cardiology, Department of Integrated Medicine I, Saitama Medical Center, Jichi Medical University School of Medicine
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Hirahara Taishi
Division of Cardiology, Saitama Medical Center, Jichi Medical University
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Ako Junya
Division of Cardiology, Department of Integrated Medicine I, Saitama Medical Center, Jichi Medical University School of Medicine
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Sugawara Yoshitaka
Division of Cardiology, Department of Integrated Medicine I, Saitama Medical Center, Jichi Medical University School of Medicine
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