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Malperfusion in acu...
Malperfusion in acute type A aortic dissection : An update from the Nordic Consortium for Acute Type A Aortic Dissection
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- Zindovic, Igor (author)
- Lund University,Lunds universitet,Thoraxkirurgi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Thoracic Surgery,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Gudbjartsson, Tomas (author)
- Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland,National University Hospital of Iceland
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- Ahlsson, Anders (author)
- Karolinska Institutet,Örebro University Hospital
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- Fuglsang, Simon (author)
- Department of Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark
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- Gunn, Jarmo (author)
- Heart Center, Turku University Hospital and University of Turku, 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 Thoracic and Cardiovascular Surgery, Aarhus University Hospital, Skejby, Denmark
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- Järvelä, Kati (author)
- 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)
- Heart Center, Tampere University Hospital, Tampere, Finland
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- Olsson, Christian (author)
- Karolinska Institutet,Karolinska University Hospital
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- Pan, Emily (author)
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland
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- Sjögren, Johan (author)
- Lund University,Lunds universitet,Thoraxkirurgi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Thoracic Surgery,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Wickbom, Anders, 1987- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Cardiothoracic and Vascular Surgery,Örebro University Hospital
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- Geirsson, Arnar (author)
- Landspitali University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland,National University Hospital of Iceland,Yale University
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- Nozohoor, Shahab (author)
- Lund University,Lunds universitet,Thoraxkirurgi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Thoracic Surgery,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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(creator_code:org_t)
- Elsevier, 2019
- 2019
- English.
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In: Journal of Thoracic and Cardiovascular Surgery. - : Elsevier. - 0022-5223 .- 1097-685X. ; 157:4, s. 1324-1333
- Related links:
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http://www.jtcvs.org...
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http://dx.doi.org/10...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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https://lup.lub.lu.s...
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https://gup.ub.gu.se...
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Abstract
Subject headings
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- Objectives: To evaluate the effect of preoperative malperfusion on 30-day and late mortality and postoperative complications using data from the Nordic Consortium for Acute Type A Aortic Dissection (ATAAD) registry.Methods: We studied 1159 patients who underwent ATAAD surgery between January 2005 and December 2014 at 8 Nordic centers. Multivariable logistic and Cox regression analyses were performed to identify independent predictors of 30-day and late mortality.Results: Preoperative malperfusion was identified in 381 of 1159 patients (33%) who underwent ATAAD surgery. Thirty-day mortality was 28.9% in patients with preoperative malperfusion and 12.1% in those without. Independent predictors of 30-day mortality included any malperfusion (odds ratio, 2.76; 95% confidence interval [CI], 1.94-3.93), cardiac malperfusion (odds ratio, 2.37; 95% CI, 1.34-4.17), renal malperfusion (odds ratio, 2.38; 95% CI, 1.23-4.61) and peripheral malperfusion (odds ratio, 1.95; 95% CI, 1.26-3.01). Any malperfusion (hazard ratio, 1.72; 95% CI, 1.21-2.43), cardiac malperfusion (hazard ratio, 1.89; 95% CI, 1.24-2.87) and gastrointestinal malperfusion (hazard ratio, 2.25; 95% CI, 1.18-4.26) were predictors of late mortality. Malperfusion was associated with significantly poorer survival at 1, 3, and 5 years (95.0% +/-0.9% vs 88.7% +/-1.9%, 90.1% +/-1.3% vs 84.0% +/-2.4%, and 85.4% +/-1.7% vs 80.8% +/-2.7%; log rank P = .009).Conclusions: Malperfusion has a significant influence on early and late outcomes in ATAAD surgery. Management of preoperative malperfusion remains a major challenge in reducing mortality associated with surgical treatment of ATAAD.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- 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
- aorta
- dissection
- malperfusion
- aorta
- dissection
- malperfusion
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Zindovic, Igor
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Gudbjartsson, To ...
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Ahlsson, Anders
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Fuglsang, Simon
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Gunn, Jarmo
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Hansson, Emma C. ...
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show more...
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Hjortdal, Vibeke
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Järvelä, Kati
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Jeppsson, Anders ...
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Mennander, Ari
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Olsson, Christia ...
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Pan, Emily
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Sjögren, Johan
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Wickbom, Anders, ...
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Geirsson, Arnar
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Nozohoor, Shahab
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show less...
- 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 Cardiac and Card ...
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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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Journal of Thora ...
- By the university
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Örebro University
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Karolinska Institutet
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Lund University
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University of Gothenburg