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Medium-term surviva...
Medium-term survival after surgery for acute Type A aortic dissection is improving
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- Olsson, Christian (author)
- Karolinska Institutet
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- Ahlsson, Anders, 1962- (author)
- Karolinska Institutet
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- Fuglsang, Simon (author)
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Skejby, Denmark
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- Geirsson, Arnar (author)
- Department of Cardiothoracic Surgery, Faculty of Medicine, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland,National University Hospital of Iceland
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- Gunn, Jarmo (author)
- Department of Cardiothoracic Surgery, Turku University Hospital, Turku, Finland
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- Hansson, Emma C., 1985 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Hjortdal, Vibeke (author)
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Skejby, Denmark
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- Jarvela, Kati (author)
- Department of Cardiothoracic Surgery, Heart Center Tampere University Hospital, Tampere, Finland
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- Jeppsson, Anders, 1960 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Mennander, Ari (author)
- Department of Cardiothoracic Surgery, Heart Center Tampere University Hospital, Tampere, Finland
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- Nozohoor, Shahab (author)
- Lund University,Lunds universitet,Thoraxkirurgi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Minimalinvasiv hjärtkirurgi vid hjärtklaffsjukdom,Forskargrupper vid Lunds universitet,Blödningsrubbningar och akut typ-A dissektion,Thoracic Surgery,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Minimal invasive cardiac surgery in valvular heart disease,Lund University Research Groups,Bleeding disorders and acute typ-A dissection,Skåne University Hospital
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- Wickbom, Anders, 1987- (author)
- Department of Cardiothoracic and Vascular Surgery, Orebro University Hospital, Orebro, Sweden
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- Zindovic, Igor (author)
- Lund University,Lunds universitet,Thoraxkirurgi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Minimalinvasiv hjärtkirurgi vid hjärtklaffsjukdom,Forskargrupper vid Lunds universitet,Blödningsrubbningar och akut typ-A dissektion,Thoracic Surgery,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Minimal invasive cardiac surgery in valvular heart disease,Lund University Research Groups,Bleeding disorders and acute typ-A dissection,Skåne University Hospital
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- Gudbjartsson, Tomas (author)
- Department of Cardiothoracic Surgery, Faculty of Medicine, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland,National University Hospital of Iceland
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(creator_code:org_t)
- 2017-09-18
- 2017
- English.
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In: European Journal of Cardio-Thoracic Surgery. - : Oxford University Press. - 1010-7940 .- 1873-734X. ; 52:5, s. 852-857
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Abstract
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- OBJECTIVES: To report long-term survival and predictors of mortality in patients included in a large, contemporary, multicentre, multinational database: Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD), which consists of 8 centres in 4 Nordic countries.METHODS: Currently, NORCAAD includes 1159 patients operated between 2005 and 2014. In 30-day survivors (n = 955, 82%), the Kaplan-Meier and Cox proportional hazard methods were used to analyse medium-term (up to 8 years) survival and relative survival versus a matched normal population. Pre- and intraoperative predictors were expressed as hazard ratio (HR) with 95% confidence interval (95% CI).RESULTS: Cumulative follow-up was 3514 patient-years with a median of 3.2 years (range 0-10.2 years). Survival was 95% (95% CI 93-96) at 1 year, 86% (95% CI 83-88) at 5 years and 76% (95% CI 72-81) at 8 years. Relative survival versus a matched normal population was 95% (95% CI 94-97) at 1 year, 90% (95% CI 87-93) at 5 years and 85% (95% CI 80-90) at 8 years. In multivariable analysis, increased age (HR 1.05 per year, 95% CI 1.04-1.07), previous abdominal or thoracic aortic repair (HR 3.2, 95% CI 1.6-6.4) and chronic renal disease (HR 2.7, 95% CI 1.2-6.2) were associated with increased medium-term mortality. Open distal anastomosis (HR 0.55, 95% CI 0.35-0.87) and operation in the 2010-2014 period (HR 0.90, 95% CI 0.83-0.97) were associated with decreased medium-term mortality.CONCLUSIONS: Medium-term survival after acute Type A aortic dissection in the NORCAAD registry is satisfactory, close to a matched normal population and improved in the later part of the study period. The use of open distal anastomosis was associated with decreased medium-term mortality.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
Keyword
- Aortic dissection
- NORCAAD
- Open distal anastomosis
- Outcomes
- Survival
- Aortic dissection
- NORCAAD
- Open distal anastomosis
- Outcomes
- Survival
Publication and Content Type
- ref (subject category)
- art (subject category)
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Olsson, Christia ...
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Ahlsson, Anders, ...
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Fuglsang, Simon
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Geirsson, Arnar
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Gunn, Jarmo
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Hansson, Emma C. ...
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Hjortdal, Vibeke
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Jarvela, Kati
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Jeppsson, Anders ...
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Mennander, Ari
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Nozohoor, Shahab
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Wickbom, Anders, ...
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Zindovic, Igor
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Gudbjartsson, To ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
- Articles in the publication
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European Journal ...
- By the university
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Örebro University
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Lund University
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Karolinska Institutet
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University of Gothenburg