Predictors of hospital mortality in type A aortic dissections: a retrospective analysis of 148 consecutive surgical patients

Goossens, D.; Schepens, Marc A.A.M.; Hamerlijnck, R; Hartman, Magdalena; Suttorp, Maarten J.; Koomen, Egbert M.; Vermeulen, F.

doi:10.1016/s0967-2109(97)00086-0

Cited by 40 publications

(26 citation statements)

References 7 publications

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“…5,[11][12][13][14]16,17,24 The similarities of variables predicting in-hospital death in these prior reports and our study support the clinical relevancy of the current predictive model. That older age is associated with worse outcomes is not surprising and is consistent with prior reports.…”

Section: Clinical Variables Associated With High In-hospital Mortalitsupporting

confidence: 73%

“…[1][2][3][4][5][6][7][8][9] Most studies that have evaluated the predictors of death for patients with aortic dissection were restricted to a small number of patients at a single center stretching over a period of years. 5,10 -18 Furthermore, these studies have focused their attention on the surgically treated cohort rather than all patients with dissection presenting to their institution.…”

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confidence: 99%

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Predicting Death in Patients With Acute Type A Aortic Dissection

et al. 2002

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Background-Given the high mortality rates in patients with type A aortic dissection, predictive tools to identify patients at increased risk of death are needed to assist clinicians for optimal treatment. Methods and Results-Accordingly, we evaluated 547 patients with this diagnosis enrolled in the International Registry of Acute Aortic Dissection (IRAD) between January 1996 and December 1999. Univariate testing followed by multivariate logistic regression analysis was performed to identify independent predictors of death. In-hospital mortality rate was 32.5% in type A dissection patients.

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Section: Clinical Variables Associated With High In-hospital Mortalitsupporting

confidence: 73%

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confidence: 99%

Predicting Death in Patients With Acute Type A Aortic Dissection

et al. 2002

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“…Such classification reflects the underlying pathophysiology of the events, which dictates treatment options. These adverse events have been associated with mortality on univariate and multivariate analyses in several studies 22,23,[29][30][31][32][33] and therefore are included as compulsory respiratory system clinical end points.…”

Section: Respiratory Systemmentioning

confidence: 99%

“…23,24,[29][30][31][32][33] Despite their prevalence, renal complications are inconsistently reported. Some studies associate renal dysfunction with creatinine levels, 29,34,35 whereas others define it according to urine output 34 or use of dialysis.…”

Section: Renal Systemmentioning

confidence: 99%

Standardizing Clinical End Points in Aortic Arch Surgery

et al. 2014

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1610S ince the introduction of hypothermic circulatory arrest for aortic arch surgery in 1975, 1 there has been considerable progress in addressing this complex surgical pathology. [2][3][4] However, the rapidity with which operative techniques have evolved has outpaced methodical appraisal of their clinical merit, leaving behind a wealth of perfunctory data. In particular, existing emphasis on neurological outcomes has neglected other critical end points, whereas inconsistent definitions and reporting formats limit the applicability of the results of some studies. Robust comparisons between institutional reports are therefore difficult, restricting critical appraisal and summary of existing surgical approaches.The International Aortic Arch Surgery Study Group (IAASSG) has been formed to enable multi-institutional collaboration to better explore the impact of surgical techniques on patient outcomes, using uniform definitions of events and clinical end points. A key endeavor is to standardize reporting formats to facilitate effective comparisons. Such a concerted effort, with the combined expertise of leading academic surgeons, paves the way for a unified language specific for aortic arch surgery that promotes closer cooperation and systematic evaluation and is essential in forming a framework of existing knowledge and guiding progress and research for the future. 5,6The IAASSG has devised a management-orientated classification system for significant clinical end points specific for aortic arch surgery and has undertaken a consensus survey of leading arch surgeons. The following report describes this classification scheme and reports the results of the consensus. Methodology Rationales of the Grading SystemA management-oriented classification system for complications, which grades adverse events by severity on the basis of the management required, is simple, reproducible, and comprehensive.7 It avoids duplication of overlapping results and limits the fluctuating ratings of negative outcomes between institutions by providing standardized definitions. 7,8 Stratifying the severity of relevant complications into grades allows more thorough analysis to be achieved to assist benchmarking of existing procedures, identifying areas in need of improvement, guiding prospective research, and evaluating the effectiveness of interventions. Such an approach has been used widely 7 and has been successfully validated by several subspecialties and procedures. [9][10][11][12][13][14] Variants of this approach have also been implemented for thoracic surgery, resulting in a feasible system that facilitates objective assessments and identifies the burden of individual complications. 15,16 Following the work by Dindo and coworkers, 7 we propose the following system for grading adverse outcomes specific for aortic arch surgery (Table 1). Clinical complications are stratified into 5 major grades, from those that are self-limiting or

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“…There can be complications such as rupture, obstruction and occlusion of certain aortic branches. It is well known that acute aortic dissection (AAD) leading to intestinal ischemia is difficult to manage and having high mortality rates (1)(2)(3)(4). It is worrisome that a lot of sufferers with atypical or insignificant clinical signs can't have the chance for early diagnose and treatment.…”

Section: Introductionmentioning

confidence: 99%