Back to Search
Start Over
Nature of Neurological Complications and Outcome After Surgery for Type A Aortic Dissection.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2024 May 15; Vol. 219, pp. 85-91. Date of Electronic Publication: 2024 Mar 06. - Publication Year :
- 2024
-
Abstract
- Surgery for type A aortic dissection (TAAD) is frequently complicated by neurologic complications. The prognostic impact of neurologic complications of different nature has been investigated in this study. The subjects of this analysis were 3,902 patients who underwent surgery for acute TAAD from the multicenter European Registry of Type A Aortic Dissection (ERTAAD). During the index hospitalization, 722 patients (18.5%) experienced stroke/global brain ischemia. Ischemic stroke was detected in 539 patients (13.8%), hemorrhagic stroke in 76 patients (1.9%) and global brain ischemia in 177 patients (4.5%), with a few patients having had findings of more than 1 of these conditions. In-hospital mortality was increased significantly in patients with postoperative ischemic stroke (25.6%, adjusted odds ratio [OR] 2.422, 95% confidence interval [CI] 1.825 to 3.216), hemorrhagic stroke (48.7%, adjusted OR 4.641, 95% CI 2.524 to 8.533), and global brain ischemia (74.0%, adjusted OR 22.275, 95% CI 14.537 to 35.524) compared with patients without neurologic complications (13.5%). Similarly, patients who experienced ischemic stroke (46.3%, adjusted hazard ratio [HR] 1.719, 95% CI 1.434 to 2.059), hemorrhagic stroke (62.8%, adjusted HR 3.236, 95% CI 2.314 to 4.525), and global brain ischemia (83.9%, adjusted HR 12.777, 95% CI 10.325 to 15.810) had significantly higher 5-year mortality than patients without postoperative neurologic complications (27.5%). The negative prognostic effect of neurologic complications on survival vanished about 1 year after surgery. In conclusion, postoperative ischemic stroke, hemorrhagic stroke, and global cerebral ischemia increased early and midterm mortality after surgery for acute TAAD. The magnitude of risk of mortality increased with the severity of the neurologic complications, with postoperative hemorrhagic stroke and global brain ischemia being highly lethal complications.<br />Competing Interests: Declaration of competing interest The authors have no competing interest to declare.<br /> (Copyright © 2024 Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Male
Female
Middle Aged
Aged
Prognosis
Hemorrhagic Stroke epidemiology
Brain Ischemia etiology
Brain Ischemia epidemiology
Risk Factors
Europe epidemiology
Retrospective Studies
Survival Rate trends
Aortic Dissection surgery
Aortic Dissection mortality
Postoperative Complications epidemiology
Registries
Aortic Aneurysm, Thoracic surgery
Aortic Aneurysm, Thoracic mortality
Hospital Mortality trends
Ischemic Stroke epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 219
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 38458584
- Full Text :
- https://doi.org/10.1016/j.amjcard.2024.03.001