Analysis Of Clinical Characteristics And Risk Factors Of In-hospital Mortality In 270 Patients With Acute Aortic Dissection

Objective To study the clinical characteristics and risk factors of in-hospital mortality in patients with acute aortic dissection.Methods The clinical data of 270 patients with acute aortic dissection from January 2013 to December 2015 were analysed retrospectively,including age,sex,past histor y,vital signs,laboratory tests,complications,in-hospital mortality,onset time and age distribution characteristics.The cilinical data of patients with type A and typ e B acute aortic dissection were compared.Patients were divided into death grou p and survival group.,and the risk factors of in-hospital mortality of patients wi th acute aortic dissection were analyzed,and the independent risk factors were a nalysed.Results1.The average age of patients with acute aortic was 55.7±12.7,the male to fem ale ratio was 3.03:1,201 patients were complicated hypertension(74.4%),5patients Marfan Sydrome(1.9%),and 77 patients smoking history(28.5%).235 patients had pa in manifestations(87%),admission systolic blood pressure,white blood cell count,Ddimers level were higher than normal.There were 45 cases with renal insufficienc y(16.7%),48 cases with pericardial effusion(17.8%),49 cases with aortic regurgitation(18.1%).44 cases died in hospital(16.3%).2.Acute aortic dissection occured in winter and spring,and are common in Janu ary,November and December.Type A and Type B acute aortic dissection are com mon in the age of 40-69 yeas old,and the propotion was higher in patients with type B in the age of elderly(age more than 70 years old).3.Compared with type B patients,type A had lower average age,systolic blood pressure,and diastolic blood pressure,but higher levels of D-dimer,higher rate of r enal insuffienciency,pericardial effusion,aortic insufficiency,and in-hospital death,th e statistical differences were significantly(P<0.05).4.Compared with the survival group,the death group had lower systolic blood pressure,diastolic blood pressure,higher D-dimer level,higher propotion of Stanfor d A,renal insufficency,and pericardial effusion,the differences were statistically sig nificant(P<0.05).And further Logistic regression anlysis showed that lower systolic blood pressure on admission,higher level of D-dimer,Stanford A,renal in sufficie ncy,pericardial effusion were independent risk factors for in-hospital death with a cute aortic dissection.Conclusion1.Acute aortic dissection were common in winter and spring,middle-aged men.Patients with acute aortic dissection offen had hypertension and smoking,clinicals were pain,admission systolic blood pressure level,white blood cell count and D-dimer level were higher,and higher propotion in complication and in-hospital d eath.2.Patients with type A acute aortic dissection had lower age,and higher blood pressure and D-dimer level,and higher propotion of complications and in-hospita l mortality than patients with type B acute aortic dissection.3.lower systolic blood pressure on admission,higher level of D-dimer,Stanford A,r enal in sufficiency,pericardial effusion were independent risk factors for in-hospita l death with acute aortic dissection,and should be noticed in clinically.