The incidence and mortality of acute thoracic aortic dissection: results from a whole nation study.

• Published in: European Journal of Cardio-Thoracic Surgery
• Main Authors: Melvinsdottir, Inga H, Lund, Sigrun H, Agnarsson, Bjarni A, Sigvaldason, Kristinn, Gudbjartsson, Tomas, Geirsson, Arnar
• Other Authors: 1 Landspitali Univ Hosp, Dept Cardiothorac Surg, Reykjavik, Iceland Organization-Enhanced Name(s) Landspitali National University Hospital Show the Organization-Enhanced name(s) 2 Univ Iceland, Fac Med, Reykjavik, Iceland Hide the Organization-Enhanced name(s) 3 Landspitali Univ Hosp, Dept Pathol, Reykjavik, Iceland Organization-Enhanced Name(s) Landspitali National University Hospital Hide the Organization-Enhanced name(s) 4 Landspitali Univ Hosp, Dept Anesthesiol, Reykjavik, Iceland Organization-Enhanced Name(s) Landspitali National University Hospital Show the Organization-Enhanced name(s) 5 Yale Univ, Sch Med, Sect Cardiac Surg, New Haven, CT USA 6 Vet Affairs Connecticut Healthcare Syst, Dept Surg, West Haven, CT USA
• Format: Article in Journal/Newspaper
• Language: English
• Published: OXFORD UNIV PRESS INC 2017
• Subjects: Æðasjúkdómar; Æðaskurðlækningar; PTT12; AAA12; TAS12; Aortic Aneurysm; Thoracic; Aortic Rupture; Smella; Iceland
• Online Access: http://hdl.handle.net/2336/620124; https://doi.org/10.1093/ejcts/ezw235

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenTo access publisher's full text version of this article click on the hyperlink at the bottom of the page Acute thoracic aortic dissection (ATAD) is a devastating condition associated with a high mortality rate. Recent reports suggest that its incidence is rising. Utilizing nationwide data comprising the whole Icelandic population, we aimed to determine the incidence, mortality rate and time-dependent mortality risk of ATAD. Data were retrospectively collected using centralized hospital discharge registries, autopsy records and Cause of Death Registry in Iceland from 1992 to 2013. Age- and gender-adjusted incidence of ATAD was 2.53/100 000/year, and no significant change in incidence was observed during the study period. The mean age was 66.9 ± 13.6 years and 66.0% (101/153) were Stanford type A. Of the whole group, 17.6% (27/153) died prior to hospital arrival, whereas the risk of death for patients who arrived alive to a hospital was 21.4% (27/126) within 24 h and 45.2% (57/126) at 30 days. During the course of the study, patients with type A dissection were more likely to undergo an operation and the management of type B dissection changed from open to endovascular repair. The 30-day mortality rate declined every year and the 5-year survival rate improved in the last third of the study. The incidence of ATAD was 2.53/100 000/year and remained constant throughout the study, contradicting recent perceptions of a rising incidence. ATAD, type A in particular, remains a highly lethal condition: Over half of all patients die within 30 days of the index event. A reduced 30-day mortality rate and an increased long-term survival rate indicate improved overall outcomes in patients with this complex condition. Landspitali University Hospital Scientific Fund University of Iceland Research Fund