Analysis of Clinical Manifestation and Risk Factors of In-hospital Death in Aortic Dissection Patients
|School||Huazhong University of Science and Technology|
|Keywords||aortic dissection pain death risk factor|
Objective:To investigate clinical characteristics and outcomes of patients with atypical aortic dissection (painless aortic dissection). To determine the risk factors of in-hospital death in aortic dissection patients.Methods: 235 patients with aortic dissection admitted to Tongji hospital from 2004 to 2008 had been analyzed. The cohort were divided into painful group and painless group by clinical symptoms and divided into death group and survival group according to whether they survived.Results:Among 235 aortic dissection patients, there were 79 cases with DeBakey typeⅠ, 6 cases with DeBakey typeⅡ, and 150 cases with DeBakey typeⅢaortic dissection. 193 patients(82.1%) were male, 42 patients(17.9%) were female. The gender ratio was 4.5:1. 21 cases(8.9%) did not feel pain (Painless group). the frequency of diabetes in the painless group is obvious higher than that in the painful group(28.6% vs 8.5%, P=0.012). 36.4% of the painless group had hypertension, less than painful group(P=0.042). There was no different between painless and painful group in 1-year follow up; 65.8% of in-hospital dead patients had typeⅠaortic dissection. Acute pericardial effusion、aortic insufficiency、ischemia of internal organs( gastrointestine, kidney)、renal insufficiency and hypotension were risks of in-hospital death. Elevate of WBC and ESR could probably indicated the in-hospital dead in some degree. Conclusion: 1. painless aortic dissection is much common in typeⅠaortic dissection or aortic dissection with diabetes. There was no different between painless and painful group in 1-year follow up. 2. Acute pericardial effusion, Aortic insufficiency, ischemia of internal organs( gastrointestine, kidney), Renal insufficiency and hypotension were risks of in-hospital death. Elevate of WBC and ESR could probably indicated the in-hospital death in some degree.