International Study on Aortic Dissection

An international group has completed an analysis of patients with aortic dissection, resulting in a checklist of characteristics present in those who died before leaving the hospital. The checklist is designed to help surgeons decide which patients with aortic dissection would likely survive surgery and those who likely would not.

The study was conducted by researchers from the International Registry of Acute Aortic Dissection, headquartered at the University of Michigan Cardiovascular Center (U-M, Ann Arbor, USA). The researchers examined the records of 547 patients treated at 18 large hospitals in six countries for type A acute aortic dissections. They looked at 290 variables, including age, gender, and medical history, to see which ones were statistically most common to those who died or to those who lived.

Among all patients, seven clinical characteristics seen upon presentation emerged as statistically most likely to be present in those who died before leaving the hospital. The seven clinical characteristics are: age over 70; female gender; abrupt onset of chest, neck, or back pain; abnormal electrocardiogram reading; pulse deficit; kidney failure, signaling a lack of blood to the kidneys; and hypotension, shock, or tamponade, signaling a lack of blood pressure and flow.

"The higher the total score, the more likely a patient is to die before leaving the hospital,” said lead author Rajendra Mehta, M.D., a clinical assistant professor of cardiology at the U-M Medical School. "Combined with other knowledge about who is best suited for surgery or other interventions, the checklist can be used by physicians anywhere to talk with patients about how to proceed.”




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