Merkle, Julia, Sabashnikov, Anton, Weber, Carolyn, Schlachtenberger, Georg, Maier, Johanna, Spieker, Anna, Eghbalzadeh, Kaveh, Deppe, Antje-Christin, Zeriouh, Mohamed, Rahmanian, Parwis B. ORCID: 0000-0002-3978-9251, Madershahian, Navid, Rustenbach, Christian, Choi, Yeong-Hoon, Kuhn-Regnier, Ferdinand, Liakopoulos, Oliver and Wahlers, Thorsten (2018). Impact of age on early outcomes and long-term survival of patients undergoing aortic repair with Stanford A dissection. Perfusion-UK, 33 (8). S. 687 - 696. LONDON: SAGE PUBLICATIONS LTD. ISSN 1477-111X

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Abstract

Objectives: Stanford A acute aortic dissection (AAD) is a life-threatening emergency, typically occurring in older patients and requiring immediate surgical repair. The aim of this study was to evaluate early outcome and short- and long-term survival of patients under and above 65 years of age. Methods: Two hundred and forty patients with Stanford A AAD underwent aortic surgical repair from January 2006 to April 2015 in our center. After statistical analysis and logistic regression analysis, Kaplan-Meier survival estimation was performed, with up to 9-year follow-up, comprising patients under and above 65 years of age. Results: The proportion of patients above 65 years of age suffering from Stanford A AAD was 50% (n=120). The group of patients above 65 years of age compared to the group under 65 years of age showed statistically significant differences in terms of higher odds ratios (OR) for hypertension (p=0.012), peripheral vascular disease (p=0.026) and tachyarrhythmia absoluta (p=0.004). Patients over 65 years of age also showed significantly poorer short- and long-term survival. Our subgroup analysis revealed that male patients (Breslow p=0.001, Log-Rank p=0.001) and patients suffering with hypertension (Breslow p=0.003, Log-Rank p=0.001) were reasonable for these results whereas younger and older female patients showed similar short- and long-term outcome (Breslow p=0.926, Log-Rank p=0.724). After stratifying all patients into 4 age groups (75years), short-term survival of the patients appeared to be significantly poorer with increasing age (Breslow p=0.026, Log-Rank p=0.008) whereas long-term survival of patients free from cerebrovascular events (Breslow p=0.0494, Log-Rank p=0.489) remained similar. Conclusions: All patients referred to our hospital for repair of Stanford A AAD with higher age had poorer short- and long-term survival, caused by male patients and patients suffering from hypertension, whereas survival of women and survival free from cerebrovascular events of the entire patient cohort was similar, irrespective of age.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Merkle, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sabashnikov, AntonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weber, CarolynUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schlachtenberger, GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maier, JohannaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spieker, AnnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eghbalzadeh, KavehUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Deppe, Antje-ChristinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zeriouh, MohamedUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rahmanian, Parwis B.UNSPECIFIEDorcid.org/0000-0002-3978-9251UNSPECIFIED
Madershahian, NavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rustenbach, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Choi, Yeong-HoonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuhn-Regnier, FerdinandUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Liakopoulos, OliverUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wahlers, ThorstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-166135
DOI: 10.1177/0267659118786332
Journal or Publication Title: Perfusion-UK
Volume: 33
Number: 8
Page Range: S. 687 - 696
Date: 2018
Publisher: SAGE PUBLICATIONS LTD
Place of Publication: LONDON
ISSN: 1477-111X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
SURGICAL OUTCOMES; SEX-DIFFERENCES; A DISSECTION; SURGERY; MANAGEMENT; MORTALITY; GENDER; RISK; REGISTRYMultiple languages
Cardiac & Cardiovascular Systems; Peripheral Vascular DiseaseMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/16613

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