Classification of the Urgency of the Procedure and Outcome of Acute Type A Aortic Dissection

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064173%3A_____%2F24%3A43926705" target="_blank" >RIV/00064173:_____/24:43926705 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11120/24:43926705

Výsledek na webu

<a href="https://doi.org/10.1016/j.amjcard.2024.01.035" target="_blank" >https://doi.org/10.1016/j.amjcard.2024.01.035</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.amjcard.2024.01.035" target="_blank" >10.1016/j.amjcard.2024.01.035</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Classification of the Urgency of the Procedure and Outcome of Acute Type A Aortic Dissection

Popis výsledku v původním jazyce

Surgery for type A aortic dissection (TAAD) is associated with high risk of early mortality. The prognostic impact of a new classification of the urgency of the procedure was evaluated in this multicenter cohort study. Data on consecutive patients who underwent surgery for acute TAAD were retrospectively collected in the multicenter, retrospective European Registry of TAAD (ERTAAD). The rates of in-hospital mortality of 3902 consecutive patients increased along with the ERTAAD procedure urgency grades: urgent procedure, 10.0%; emergency procedure grade 1, 13.3%; emergency procedure grade 2, 22.1%; salvage procedure grade 1, 45.6%; and salvage procedure grade 2, 57.1% (p&lt;0.0001). Preoperative arterial lactate correlated with the urgency grades. Inclusion of the ERTAAD procedure urgency classification significantly improved the area under the receiver operating characteristics curves of the regression model as well as the integrated discrimination indices and the net reclassification indices. The risk of postoperative stroke/global brain ischemia, mesenteric ischemia, lower limb ischemia, dialysis, and acute heart failure increased along with the urgency grades. In conclusion, the urgency of surgical repair of acute TAAD seems to have a significant impact on the risk of in-hospital mortality may be useful to improve the stratification of the operative risk of these critically ill patients. This study showed that salvage surgery for TAAD is justified because half of patients may survive to discharge.

Název v anglickém jazyce

Classification of the Urgency of the Procedure and Outcome of Acute Type A Aortic Dissection

Popis výsledku anglicky

Surgery for type A aortic dissection (TAAD) is associated with high risk of early mortality. The prognostic impact of a new classification of the urgency of the procedure was evaluated in this multicenter cohort study. Data on consecutive patients who underwent surgery for acute TAAD were retrospectively collected in the multicenter, retrospective European Registry of TAAD (ERTAAD). The rates of in-hospital mortality of 3902 consecutive patients increased along with the ERTAAD procedure urgency grades: urgent procedure, 10.0%; emergency procedure grade 1, 13.3%; emergency procedure grade 2, 22.1%; salvage procedure grade 1, 45.6%; and salvage procedure grade 2, 57.1% (p&lt;0.0001). Preoperative arterial lactate correlated with the urgency grades. Inclusion of the ERTAAD procedure urgency classification significantly improved the area under the receiver operating characteristics curves of the regression model as well as the integrated discrimination indices and the net reclassification indices. The risk of postoperative stroke/global brain ischemia, mesenteric ischemia, lower limb ischemia, dialysis, and acute heart failure increased along with the urgency grades. In conclusion, the urgency of surgical repair of acute TAAD seems to have a significant impact on the risk of in-hospital mortality may be useful to improve the stratification of the operative risk of these critically ill patients. This study showed that salvage surgery for TAAD is justified because half of patients may survive to discharge.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Rok uplatnění

2024

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

American Journal of Cardiology

ISSN

0002-9149

e-ISSN

1879-1913

Svazek periodika

217

Číslo periodika v rámci svazku

April

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

9

Strana od-do

59-67

Kód UT WoS článku

001219152300001

EID výsledku v databázi Scopus

2-s2.0-85187316505