Navigation Links
Mortality for acute aortic dissection near 1 percent per hour during initial onset
Date:3/9/2013

The belief among medical professionals in the 1950s that the mortality rate for type A acute aortic dissection during the initial 24 hours was one to two percent per hour appears to hold true in the contemporary era of treatment, based on a review of the large-scale IRAD registry being presented March 9 at the American College of Cardiology (ACC) Scientific Sessions.

"In the 1950s, the medical literature suggested that the mortality rate for type A acute aortic dissection was one percent per hour, but we have limited information about the current rate in an era where advanced diagnostic imaging is often readily available," explains lead study author, Craig E. Strauss, MD, MPH, a research cardiologist at the Minneapolis Heart Institute Foundation and physician at the Minneapolis Heart Institute (MHI) at Abbott Northwestern Hospital in Minneapolis. "We reviewed data from the large-scale IRAD registry to obtain a real-world understanding of this patient population in the contemporary era."

The International Registry of Acute Aortic Dissections (IRAD) is a consortium of research centers, including MHI, which evaluates the management and outcomes of acute aortic dissection. Established in 1996, IRAD currently has 30 large referral centers in 11 countries participating in the registry.

"While aortic dissections are a less common diagnosis than a heart attack, patients present in a similar fashion with significant chest pain or back pain, and the mortality risk is very real, which is why rapid and appropriate diagnosis and treatment is so important," says study co-author, Kevin Harris, MD, research cardiologist at the Minneapolis Heart Institute Foundation.

An aortic dissection is a tear in the wall of the aorta of the heart that allows blood to flow within the layers of the aorta. Early diagnosis and treatment of this illness is critical for survival. Certain types (type A) of dissections, if left untreated, kill 33% of patients within the first 24 hours, 50% of patients within 48 hours and 75% of patients within two weeks.

For this study, the researchers included 1,969 patients (mean age 61.1, 68.1% male) diagnosed with type A acute aortic dissection in IRAD between January 1996 and February 2012. Of those patients, 195 were managed medically, as opposed to receiving surgery.

The initial 24-hour mortality was higher for the medically managed group, compared with surgically managed patients, based on time from symptom onset (18.5% vs. 3.7%).

The mortality rate per hour during the initial 24 hours was 0.22% for all cases: 0.15% for surgically managed cases and 0.77% for medically managed cases. Among those patients managed medically, the rationale against surgery included age (41.7%), co-morbid illness (64.8%), patient refusal (27.1%), or other (21.3%).

"Essentially, we learned that the mortality rate for medically treated patients with acute aortic dissection hasn't changed significantly in the past 60 years, despite improvements in pharmacological treatment with beta-blockers and major advancements in diagnostic imaging tools," says Strauss. CT imaging is the most common method of diagnosis.

"The take-home message from our findings is that mortality is still extremely high for these patients, which calls for rapid diagnosis and rapid intervention through surgery," adds Harris, who is also co-director of the Acute Aortic Dissection Program and director of the echocardiography laboratory at the Minneapolis Heart Institute at Abbott Northwestern Hospital in Minneapolis. "These patients should not be medically managed throughout the night, for instance. If they are an appropriate candidate for surgery, they should be treated immediately."


'/>"/>

Contact: Steve Goodyear
sgoodyear@mhif.org
612-863-1658
Minneapolis Heart Institute Foundation
Source:Eurekalert

Related medicine news :

1. Lack of aspirin before angioplasty linked with higher mortality
2. Praeclarus Press Launches the One Every 21 Seconds Campaign to Increase Awareness on the Role of Breastfeeding in Reducing Racial/Ethnic Disparities in Infant Mortality
3. Is there a link between coffee drinking and mortality?
4. Bronchiectasis increases mortality risk in moderate-to-severe COPD
5. Severity of emphysema predicts mortality
6. Cancer mortality down 20 percent from 1991 peak
7. Breast cancer mortality has not declined in women over 85
8. UCSF teams tackle childhood mortality and river blindness
9. Postpartum depression prevalent in under-developed countries, could impact baby health and mortality
10. Pursuing literary immortality illuminates how the mind works, finds CWRU researcher
11. Ability to sit and rise from the floor is closely correlated with all-cause mortality risk
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... June 27, 2016 , ... TherapySites, the ... affiliation with Tennessee Counseling Association. This new relationship allows TherapySites to ... Counseling Association, adding exclusive benefits and promotional offers. , "TCA is extremely excited ...
(Date:6/27/2016)... ... June 27, 2016 , ... TopConsumerReviews.com recently awarded their ... Eyeglasses . , Millions of individuals in the United States and Canada wear eyeglasses. ... way to both correct vision and make a fashion statement. Even celebrities use glasses ...
(Date:6/26/2016)... ... June 26, 2016 , ... Pixel Film Studios Released ProSlice Levels, ... editors can give their videos a whole new perspective by using the title ... Pixel Film Studios. , ProSlice Levels contains over 30 Different presets to choose ...
(Date:6/26/2016)... , ... June 26, 2016 , ... ... once they have been diagnosed with endometriosis. These women need a treatment plan ... require a comprehensive approach that can help for preservation of fertility and ultimately ...
(Date:6/25/2016)... ... June 25, 2016 , ... The temporary closing of Bruton Memorial Library on June ... , brings up a new, often overlooked aspect of head lice: the parasite’s ability to ... is not a common occurrence, but a necessary one in the event that lice have ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... DUBLIN , June 23, 2016 ... "Dialysis Devices Global Market - Forecast to 2022" report ... is the treatment method for the patients with kidney failure, ... and excess fluid from the patient,s blood and thus the ... sodium, potassium and chloride in balance. Increasing ...
(Date:6/23/2016)... , June 23, 2016 ... "Pharmaceutical Excipients Market by Type (Organic Chemical (Sugar, ... Formulation (Oral, Topical, Coating, Parenteral) - Global Forecast to ... The global pharmaceutical excipients market ... at a CAGR of 6.1% in the forecast period ...
(Date:6/23/2016)... 2016 Roche (SIX: RO, ROG; OTCQX: RHHBY) ... Elecsys BRAHMS PCT (procalcitonin) assay as a dedicated testing ... With this clearance, Roche is the first IVD company ... for sepsis risk assessment and management. PCT ... PCT levels in blood can aid clinicians in assessing ...
Breaking Medicine Technology: