#Irad dissection series#

A risk prediction model with control for age and gender showed hypotension/shock (OR 23.8), absence of chest/back pain on presentation (OR 3.5) and branch vessel involvement (OR 2.9) вЂ“ collectively named вЂthe deadly triadвЂ™ вЂ“ to be independent predictors of in-hospital death. Similar to type A dissection, advanced age, rupture, shock and malperfusion are important independent predictors of early mortality. 15 However, patients who develop ischaemic complications such as renal failure, visceral ischaemia or contained rupture often require urgent aortic repair, which carries a mortality of 20% by day two and 25% by day 30. Patients with uncomplicated type B dissection have a 30-day mortality of 10.5%. Type B DissectionДЄcute aortic dissection affecting the descending aorta is less lethal than type A dissection. This analysis provides a useful and simple bedside risk prediction tool that could be used by physicians for determining the prognosis of patients with acute type A AAS. 4Д¬ompared with those without Marfan syndrome, those with the syndrome (5%) were considerably younger (35в‘2 versus 64в‘3 years p70 years (OR 1.70), abrupt onset of chest pain (OR 2.50) hypotension/shock/ tamponade (OR 2.97), kidney failure (OR 4.77), pulse deficit (OR 2.03) and abnormal ECG (OR 1.77) area under receiver operating curve 0.74.

After adjustment for age and hypertension, mortality was higher among women than among men: type A dissection was associated with a higher surgical mortality of 32% compared with 22% in men. In-hospital complications of hypotension and tamponade occurred with greater frequency in women, resulting in higher in-hospital mortality compared with men (30 versus 21% p=0.001). 3ДЄlthough less frequently affected by AAS (32%), women were significantly older and were diagnosed later than men. Fewer elderly than younger patients were managed surgically (64 versus 86% p70 years as an independent predictor of hospital death for acute type A dissection. In the total registry, 5 and 4% of cases of acute aortic dissection were thought to be related to MarfanвЂ™s syndrome and iatrogenic causes, respectively. A history of atherosclerosis was present in 31% of patients and a history of cardiac surgery in 18%.

#Irad dissection series#

The most common predisposing factor for AAS in the IRAD series was hypertension (72%). The IRAD registry provides new and valuable information regarding demographics, presenting symptoms and signs, diagnostic imaging, management and outcome of AAS.

Collected data forms included more than 290 variables analysed by the co-ordinating centre at the University of Michigan.

The IRAD is an observational registry with more than 1,500 patients enrolled at 21 tertiary centres in six countries. It represents a unique opportunity to assess the current presentation, management and outcome of acute aortic syndrome (AAS). The International Registry of Acute Aortic Dissection (IRAD) was established in 1996, enrolling patients at large referral centres worldwide.