Journal
AMERICAN JOURNAL OF MEDICINE
Volume 126, Issue 8, Pages -Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjmed.2013.01.020
Keywords
Aorta; Dissecting aneurysm; Survival analyses; Thoracic surgery
Categories
Funding
- University of Michigan Health System
- Varbedian Fund for Aortic Research
- Hewlett Foundation
- Mardigian Foundation
- Gore Inc.
Ask authors/readers for more resources
BACKGROUND: The classification of aortic dissection into acute (<14 days from symptom onset) versus chronic (>= 14 days) is based on survival estimates of patients treated decades before modern diagnostic and treatment modalities were available. A new classification of aortic dissection in the current era may provide clinicians with a more precise method of characterizing the interaction of time, dissection location, and treatment type with survival. METHODS: We developed separate Kaplan-Meier survival curves for Type A and Type B aortic dissection using data from the International Registry of Aortic Dissection (IRAD). Daily survival was stratified based on type of therapy provided: medical therapy alone (medical), nonsurgical intervention plus medical therapy (endovascular), and open surgery plus medical therapy (surgical). The log-rank statistic was used to compare the survival curves of each management type within Type A and Type B aortic dissection. RESULTS: There were 1815 patients included, 67.3% male with mean age 62.0 +/- 14.2 years. When survival curves were constructed, 4 distinct time periods were noted: hyperacute (symptom onset to 24 hours), acute (2-7 days), subacute (8-30 days), and chronic (>30 days). Overall survival was progressively lower through the 4 time periods. CONCLUSIONS: This IRAD classification system can provide clinicians with a more robust method of characterizing survival after aortic dissection over time than previous methods. This system will be useful for treating patients, counseling patients and families, and studying new diagnostic and treatment methods. (C) 2013 Elsevier Inc. All rights reserved.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available