Christian Olsson1, Anders Ahlsson2, Simon Fuglsang3, Arnar Geirsson4, Jarmo Gunn5, Emma C Hansson6,7, Vibeke Hjortdal3, Kati Jarvela8, Anders Jeppsson6,7, Ari Mennander8, Shahab Nozohoor9, Anders Wickbom2, Igor Zindovic9, Tomas Gudbjartsson4. 1. Department of Thoracic and Cardiovascular Surgery, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden. 2. Department of Cardiothoracic and Vascular Surgery, Orebro University Hospital, Orebro, Sweden. 3. Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Skejby, Denmark. 4. Department of Cardiothoracic Surgery, Faculty of Medicine, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland. 5. Department of Cardiothoracic Surgery, Turku University Hospital, Turku, Finland. 6. Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden. 7. Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 8. Department of Cardiothoracic Surgery, Heart Center Tampere University Hospital, Tampere, Finland. 9. Department of Cardiothoracic Surgery, Skane University Hospital and Lund University, Lund, Sweden.
Abstract
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.
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.
Authors: Caleb R Matthews; Mackenzie Madison; Lava R Timsina; Niharika Namburi; Zainab Faiza; Lawrence S Lee Journal: Sci Rep Date: 2021-02-10 Impact factor: 4.379
Authors: Kotaro Hirakawa; Atsuko Nakayama; Masakazu Saitoh; Kentaro Hori; Tomoki Shimokawa; Tomohiro Iwakura; Go Haraguchi; Mitsuaki Isobe Journal: Int J Environ Res Public Health Date: 2022-10-09 Impact factor: 4.614