Comparison of imaging characteristics for mortality risk analysis between young and older acute aortic dissection patients

Abstract

Background There are differences between young and older patients diagnosed with acute aortic dissection. We aimed to explore the differences in echocardiographic and computed tomography angiography (CTA) characteristics between the young and the older patients diagnosed with acute aortic dissection. Methods The data from 1220 patients with aortic dissection were collected. They were divided into the young and the older groups with the age threshold set at 45 years old. The basic information and imaging data were collected and compared between the two groups. Univariate regression was used to find the risk factors for mortality in each group. Results Echocardiographic results showed the proportion of left ventricular enlargement (young vs older, 39.9% vs 26.9%, p‐value <.001) and left ventricular dysfunction (22.3% vs 14.1%, p‐value ​​smaller than .001) in the young group was significantly higher. Although there is no statistically significant difference in mortality within 60 days after admission (12.0% vs 15.1%, p‐value equals to .164), the involvements of aortic branches were the risk factor for the mortality in the young group. For the older patients, the left ventricular remodeling detected by echocardiography (left atrial enlargement, ascending aortic dilation, aortic regurgitation) and decreased heart function were the risk factors for mortality. Conclusions The mortality of the young and the older groups with acute aortic dissection are comparable. The involvements of aortic branches were the mortality risk factors in the young patients while the structural and functional change of the left ventricle detected by echocardiography was the mortality risk factor for the older patients.

Risk factors for prolonged postoperative ICU stay in the patients with Stanford type A aortic dissection

“…However, the association between age and emergency surgery remains controversial. First, for younger patients, the surgery strategy mainly depends on the involvement of aortic branches, whereas for older patients, the strategy mainly focuses on the structure and function of the left ventricle [ 22 ]. Older age (≥ 80y) is associated with higher intraoperative mortality compared with conservative treatment.…”